Provider Demographics
NPI:1629411426
Name:MCNEAL, LATRICE (LPC)
Entity Type:Individual
Prefix:
First Name:LATRICE
Middle Name:
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E FM 1382
Mailing Address - Street 2:SUITE 3-612
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6047
Mailing Address - Country:US
Mailing Address - Phone:469-300-1115
Mailing Address - Fax:
Practice Address - Street 1:445 E FM 1382
Practice Address - Street 2:SUITE 3-612
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-6047
Practice Address - Country:US
Practice Address - Phone:469-300-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional