Provider Demographics
NPI:1124335385
Name:MCNEAL, KALI
Entity type:Individual
Prefix:MS
First Name:KALI
Middle Name:
Last Name:MCNEAL
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 1:19 HIGH ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3008
Mailing Address - Country:US
Mailing Address - Phone:617-412-7729
Mailing Address - Fax:
Practice Address - Street 1:19 HIGH ST
Practice Address - Street 2:APT. 3
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3008
Practice Address - Country:US
Practice Address - Phone:617-412-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator