Provider Demographics
NPI:1770659237
Name:KUNEYL, MARGARET ANN (OT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:KUNEYL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 AUTUMN PARK TRCE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7421
Mailing Address - Country:US
Mailing Address - Phone:678-524-3451
Mailing Address - Fax:770-921-7380
Practice Address - Street 1:457 AUTUMN PARK TRCE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7421
Practice Address - Country:US
Practice Address - Phone:678-524-3451
Practice Address - Fax:770-921-7380
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002948174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000909488DMedicaid