Provider Demographics
NPI:1831390996
Name:MYERS, KARRIE RILEY (MA)
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:RILEY
Last Name:MYERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WINDOM
Mailing Address - State:MN
Mailing Address - Zip Code:56101-1414
Mailing Address - Country:US
Mailing Address - Phone:507-832-8220
Mailing Address - Fax:507-832-8221
Practice Address - Street 1:1016 3RD AVE
Practice Address - Street 2:
Practice Address - City:WINDOM
Practice Address - State:MN
Practice Address - Zip Code:56101-1414
Practice Address - Country:US
Practice Address - Phone:507-832-8220
Practice Address - Fax:507-832-8221
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0931106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist