Provider Demographics
NPI:1578972451
Name:MCNEILLY, HEATHER CLARE (CMT)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:CLARE
Last Name:MCNEILLY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 MARIGOLD COURT
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-0000
Mailing Address - Country:US
Mailing Address - Phone:510-290-0162
Mailing Address - Fax:
Practice Address - Street 1:1716 MARIGOLD COURT
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-0000
Practice Address - Country:US
Practice Address - Phone:510-290-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor