Provider Demographics
NPI:1518297761
Name:MCNEILL, KILEY NONTELL (BFA)
Entity Type:Individual
Prefix:MRS
First Name:KILEY
Middle Name:NONTELL
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:BFA
Other - Prefix:MS
Other - First Name:KILEY
Other - Middle Name:NONTELL
Other - Last Name:ROMANOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BFA
Mailing Address - Street 1:1100 E MARKET ST
Mailing Address - Street 2:HOME OF THE INNOCENTS
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241
Mailing Address - Country:US
Mailing Address - Phone:502-596-1246
Mailing Address - Fax:502-596-1420
Practice Address - Street 1:1100 EAST MARKET ST.
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-596-1252
Practice Address - Fax:502-596-1420
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst