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General NPI Number Information
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NPI Number | 1013355049
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Entity Type | Individual
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Provider Name | LARI MIKEL MEYER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 1219 N CASS ST
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City | MILWAUKEE
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State | WI
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Zip | 53202-2770
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Country | US
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Telephone | 414-291-9487
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 N CASS ST
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City | MILWAUKEE
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State | WI
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Zip | 53202-2770
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Country | US
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Telephone | 414-291-9487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3025-57
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6656
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7959
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License Number State | FL
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