Provider Demographics
NPI:1205991478
Name:GARLIT BARBER, MYRA ELAINE (M ED, LISAC)
Entity type:Individual
Prefix:MS
First Name:MYRA
Middle Name:ELAINE
Last Name:GARLIT BARBER
Suffix:
Gender:F
Credentials:M ED, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2291 E PALO VERDE ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-3621
Mailing Address - Country:US
Mailing Address - Phone:928-726-0491
Mailing Address - Fax:928-314-0717
Practice Address - Street 1:2291 E PALO VERDE ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-3621
Practice Address - Country:US
Practice Address - Phone:928-726-0491
Practice Address - Fax:928-314-0717
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10223101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLISAC-10223OtherLICENSED SUBSTANCE CNSLR