Provider Demographics
NPI:1558944579
Name:MYERS, LENA
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 E MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:NC
Mailing Address - Zip Code:28634-9134
Mailing Address - Country:US
Mailing Address - Phone:336-870-1116
Mailing Address - Fax:
Practice Address - Street 1:1016 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-9472
Practice Address - Country:US
Practice Address - Phone:336-667-9261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist