Individual
GARY D. MCNEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNS
Contact information
Practice address
474 MAIN ST, SPRINGVALE, ME 04083-1409
(207) 324-1500
(207) 490-5263
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC184
ME
163W00000X
Registered Nurse
RN27793
ME
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
CNS84088
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269560099
—
ME
Enumeration date
08/05/2006
Last updated
09/24/2012
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