Provider Demographics
NPI:1295008647
Name:MYERS, JOANIE MICHELL (MI#0297)
Entity Type:Individual
Prefix:MS
First Name:JOANIE
Middle Name:MICHELL
Last Name:MYERS
Suffix:
Gender:F
Credentials:MI#0297
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-3010
Mailing Address - Country:US
Mailing Address - Phone:775-217-8451
Mailing Address - Fax:775-428-1035
Practice Address - Street 1:502 E JOHN ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3099
Practice Address - Country:US
Practice Address - Phone:775-209-4007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI#0297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist