Provider Demographics
NPI:1902131089
Name:O'NEAL, ROBIN SUSAN
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUSAN
Last Name:O'NEAL
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 1:3926 VINEYARD GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-5229
Mailing Address - Country:US
Mailing Address - Phone:513-528-1757
Mailing Address - Fax:
Practice Address - Street 1:3926 VINEYARD GREEN DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-5229
Practice Address - Country:US
Practice Address - Phone:513-528-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency