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General NPI Number Information
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NPI Number | 1619425097
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Entity Type | Organization
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Legal Business Name | CHANEL MYERS, LMFT, LLC8
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 292 ELMWOOD CIR
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City | CHESHIRE
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State | CT
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Zip | 06410-4211
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Country | US
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Telephone | 203-519-7495
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Fax |
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Provider Business Mailing Address
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Address Line | 292 ELMWOOD CIR
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City | CHESHIRE
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State | CT
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Zip | 06410-4211
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHANEL MYERS
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Credential | LMFT
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Telephone | 203-494-7544
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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 | 001803
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License Number State | CT
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