Provider Demographics
NPI:1396483517
Name:MYERS, KAREN WOFFINDEN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:WOFFINDEN
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 1:44 E 130 N
Mailing Address - Street 2:
Mailing Address - City:LA VERKIN
Mailing Address - State:UT
Mailing Address - Zip Code:84745-5519
Mailing Address - Country:US
Mailing Address - Phone:435-327-0462
Mailing Address - Fax:
Practice Address - Street 1:415 N STATE ST.
Practice Address - Street 2:STE 201 ROOM #3
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-2350
Practice Address - Country:US
Practice Address - Phone:435-327-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11429220-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist