Provider Demographics
NPI:1023650264
Name:MCFEELY, MAEVE LEONIA
Entity type:Individual
Prefix:
First Name:MAEVE
Middle Name:LEONIA
Last Name:MCFEELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BERWICK DR
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1611
Mailing Address - Country:US
Mailing Address - Phone:814-777-4074
Mailing Address - Fax:
Practice Address - Street 1:103 BERWICK DR
Practice Address - Street 2:
Practice Address - City:BOALSBURG
Practice Address - State:PA
Practice Address - Zip Code:16827-1611
Practice Address - Country:US
Practice Address - Phone:814-777-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
OHAT0061942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer