Provider Demographics
NPI:1124710652
Name:SIMIEN, MYLES
Entity type:Individual
Prefix:
First Name:MYLES
Middle Name:
Last Name:SIMIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N 6TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4119
Mailing Address - Country:US
Mailing Address - Phone:318-737-7201
Mailing Address - Fax:318-737-7693
Practice Address - Street 1:403 N 6TH ST STE 2
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4119
Practice Address - Country:US
Practice Address - Phone:318-737-7201
Practice Address - Fax:318-737-7693
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health