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General NPI Number Information
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NPI Number | 1295008647
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Entity Type | Individual
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Provider Name | JOANIE MICHELL MYERS MI#0297
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Gender | Female
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 502 E JOHN ST
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City | CARSON CITY
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State | NV
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Zip | 89706-3099
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Country | US
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Telephone | 775-209-4007
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Fax |
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Provider Business Mailing Address
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Address Line | 120 N BROADWAY ST
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City | FALLON
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State | NV
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Zip | 89406-3010
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Country | US
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Telephone | 775-217-8451
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Fax | 775-428-1035
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MI#0297
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License Number State | NV
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