Provider Demographics
NPI:1730845066
Name:MACNEILL, STEPHANIE (MHSC, RD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MACNEILL
Suffix:
Gender:F
Credentials:MHSC, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 OAK BLISS CRESCENT
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:ON
Mailing Address - Zip Code:L6M3K2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2129 OAK BLISS CRESCENT
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:ON
Practice Address - Zip Code:L6M3K2
Practice Address - Country:CA
Practice Address - Phone:905-617-4009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Single Specialty