Provider Demographics
NPI:1780041145
Name:NEAL, ALAINA PATRICE (LMT, CLT, CWP)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:PATRICE
Last Name:NEAL
Suffix:
Gender:F
Credentials:LMT, CLT, CWP
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:PATRICE
Other - Last Name:BOCKBRADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2929 KENNY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2415
Mailing Address - Country:US
Mailing Address - Phone:614-769-7687
Mailing Address - Fax:
Practice Address - Street 1:2929 KENNY RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2415
Practice Address - Country:US
Practice Address - Phone:614-769-7687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.020691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist