Provider Demographics
NPI:1427516046
Name:MCNEELEY, MARGO (LAC)
Entity type:Individual
Prefix:MRS
First Name:MARGO
Middle Name:
Last Name:MCNEELEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:MARGO
Other - Middle Name:
Other - Last Name:SLUSARENKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:300 S PUEBLO AVE
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2241
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2937
Practice Address - Country:US
Practice Address - Phone:714-906-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist