Provider Demographics
NPI:1306688908
Name:NEAL, HAILEY M (MSW)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:M
Last Name:NEAL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:M
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:3247 STONY FORK RD
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-7933
Mailing Address - Country:US
Mailing Address - Phone:570-439-7227
Mailing Address - Fax:
Practice Address - Street 1:3247 STONY FORK RD
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-7933
Practice Address - Country:US
Practice Address - Phone:570-439-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2411298104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker