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General NPI Number Information
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NPI Number | 1730494907
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Entity Type | Individual
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Provider Name | DENISE L MYERS M.ED.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 914 E BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40204-1037
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Country | US
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Telephone | 502-589-8600
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Fax | 502-589-8771
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Provider Business Mailing Address
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Address Line | 3801 SPRINGHURST BLVD. SUITE 205
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City | LOUISVILLE
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State | KY
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Zip | 40241
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Country | US
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Telephone | 502-792-9117
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Fax | 855-645-1517
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 171484
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License Number State | KY
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