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General NPI Number Information
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NPI Number | 1477144103
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Entity Type | Organization
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Legal Business Name | MYERS DAVIS LIFE COACHING, INC
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 1141 E MAIN ST STE 102
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City | BATESVILLE
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State | AR
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Zip | 72501-3000
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Country | US
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Telephone | 870-569-1052
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Fax | 870-569-8130
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Provider Business Mailing Address
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Address Line | 1141 E MAIN ST STE 102
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City | BATESVILLE
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State | AR
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Zip | 72501-3000
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Country | US
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Telephone | 870-569-1052
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Fax | 870-569-8130
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELA DAVIS
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Credential | CPLC
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Telephone | 870-569-1052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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