Provider Demographics
NPI:1447610852
Name:MYERS, MICHELLE (MFTI)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 CREEKSIDE DR
Mailing Address - Street 2:APT A201
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5562
Mailing Address - Country:US
Mailing Address - Phone:707-799-9891
Mailing Address - Fax:
Practice Address - Street 1:1000 WARD ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-1360
Practice Address - Country:US
Practice Address - Phone:707-799-9891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health