Provider Demographics
NPI:1366949901
Name:O'NEIL, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:O'NEIL
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 1:2105 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-1524
Mailing Address - Country:US
Mailing Address - Phone:803-796-6179
Mailing Address - Fax:
Practice Address - Street 1:2105 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-1524
Practice Address - Country:US
Practice Address - Phone:803-796-6179
Practice Address - Fax:803-807-9881
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty