Provider Demographics
NPI:1477353258
Name:MCNEIL, AUDRIANNA
Entity type:Individual
Prefix:
First Name:AUDRIANNA
Middle Name:
Last Name:MCNEIL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1564 COUNTY ROAD 134
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-0346
Mailing Address - Country:US
Mailing Address - Phone:320-229-4950
Mailing Address - Fax:
Practice Address - Street 1:1564 COUNTY ROAD 134
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-0346
Practice Address - Country:US
Practice Address - Phone:320-229-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical