Provider Demographics
NPI:1760260897
Name:O'NEILL, MICHELLE M (RCSWI)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16031 MAGNOLIA CREEK LN
Mailing Address - Street 2:
Mailing Address - City:MONTVERDE
Mailing Address - State:FL
Mailing Address - Zip Code:34756-3776
Mailing Address - Country:US
Mailing Address - Phone:140-776-6320
Mailing Address - Fax:
Practice Address - Street 1:16031 MAGNOLIA CREEK LN
Practice Address - Street 2:
Practice Address - City:MONTVERDE
Practice Address - State:FL
Practice Address - Zip Code:34756-3776
Practice Address - Country:US
Practice Address - Phone:407-766-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical