Provider Demographics
NPI:1811185788
Name:MYERS, REGINA K (LMHP)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:K
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:DIXIE
Mailing Address - State:WA
Mailing Address - Zip Code:99329-0154
Mailing Address - Country:US
Mailing Address - Phone:509-301-3270
Mailing Address - Fax:
Practice Address - Street 1:103 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-1900
Practice Address - Country:US
Practice Address - Phone:509-301-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008385101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health