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General NPI Number Information
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NPI Number | 1720415169
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Entity Type | Individual
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Provider Name | LAURA KNOLL MYERS M.S.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 2001 S BARRINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90025-5363
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Country | US
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Telephone | 586-335-2872
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 CALLE LAUREL APT 409
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City | SAN JUAN
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State | PR
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Zip | 00913-4606
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Country | US
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Telephone | 619-933-6940
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 76723
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 89833
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License Number State | CA
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