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General NPI Number Information
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NPI Number | 1366794349
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Entity Type | Individual
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Provider Name | NADENIA F MYRON LPC,LISAC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 10005 E OSBORN RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85256-4019
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Country | US
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Telephone | 480-362-5525
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Fax | 480-362-7586
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Provider Business Mailing Address
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Address Line | 10005 E OSBORN RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85256-4019
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Country | US
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Telephone | 480-362-5525
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Fax | 480-362-7586
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC-1062
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-11077
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License Number State | AZ
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