Doctor Name: | MR. NEIL DAVID MACGINNIS |
NPI Number: | 1275820409 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 2400 S Ridgewood Ave Suite 32 South Daytona, FL - 321193097 |
Business Phone Number: | 3863047600 |
Business Fax Number: | |
Mailing Address: | 549 Antelope Dr, DELTONA |
State: | FL |
Postal Code: | 327253201 |
Phone Number: | 3865476643 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2011 |
NPI Last Update Date: | 07/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |