Provider Demographics
NPI:1316149487
Name:MCNEIL, BRENDA CAROL (MA)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:CAROL
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 CHARMING AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5545
Mailing Address - Country:US
Mailing Address - Phone:469-454-4253
Mailing Address - Fax:469-454-4253
Practice Address - Street 1:428 CHARMING AVE
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5545
Practice Address - Country:US
Practice Address - Phone:469-454-4253
Practice Address - Fax:469-454-4253
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51687237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter