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General NPI Number Information
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NPI Number | 1750444923
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Entity Type | Individual
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Provider Name | MYRL CASE L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 2137 OFFICE PARK DR SUITE E
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City | SAN ANGELO
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State | TX
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Zip | 76904-6893
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Country | US
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Telephone | 325-234-3284
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Fax |
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Provider Business Mailing Address
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Address Line | 4406 GRAYBURG DR
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City | SAN ANGELO
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State | TX
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Zip | 76904-4593
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Country | US
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Telephone | 325-234-3284
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11511
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License Number State | TX
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