Provider Demographics
NPI:1639542285
Name:MYAL, JAMILAH (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:JAMILAH
Middle Name:
Last Name:MYAL
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 S JEFFERSON DAVIS PKWY STE 325
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1234
Mailing Address - Country:US
Mailing Address - Phone:504-821-7085
Mailing Address - Fax:504-304-2276
Practice Address - Street 1:1050 S JEFFERSON DAVIS PKWY STE 325
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1234
Practice Address - Country:US
Practice Address - Phone:504-821-7085
Practice Address - Fax:504-304-2276
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist