| Doctor Name: | DR. MARY THERESE O'NEIL |
| NPI Number: | 1104132596 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | TBA |
| Business Practice Address: | 311 South Third Street Bardstown, KY - 40004 |
| Business Phone Number: | 2707652605 |
| Business Fax Number: | |
| Mailing Address: | 311 South Third Street, BARDSTOWN |
| State: | KY |
| Postal Code: | 40004 |
| Phone Number: | 2707652605 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2010 |
| NPI Last Update Date: | 06/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | TBA |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |