Provider Demographics
NPI:1871831891
Name:MYERS, LAURA (MS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 S ANN ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1304
Mailing Address - Country:US
Mailing Address - Phone:734-323-0566
Mailing Address - Fax:734-169-8033
Practice Address - Street 1:216 S ANN ARBOR ST
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1304
Practice Address - Country:US
Practice Address - Phone:734-323-0566
Practice Address - Fax:734-169-8033
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst