Provider Demographics
NPI:1881673366
Name:MCNEIL, SUSAN E (EDD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5083 WHITE CHAPEL LN
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7000
Mailing Address - Country:US
Mailing Address - Phone:513-583-5409
Mailing Address - Fax:
Practice Address - Street 1:9200 MONTGOMERY RD
Practice Address - Street 2:STE. 13A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7789
Practice Address - Country:US
Practice Address - Phone:513-791-8499
Practice Address - Fax:513-791-5895
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5098103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH16161816900Medicare ID - Type Unspecified