MEDICARE: MS. ANNE MIRIAM MYERS PC, CDCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C.1200507	OH

General Provider Information

NPI Number	:	1215366471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE MIRIAM MYERS PC, CDCA

Provider Business Mailing Address
First Line	:	6940 STONY POINT RD NW
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-7287
Country	:	US
Telephone Number	:	330-243-1438
Fax Number	:

Provider Business Practice Location Address
First Line	:	6940 STONY POINT RD NW
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-7287
Country	:	US
Telephone Number	:	330-243-1438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2013
Last Update Date	:	11/07/2013

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