Provider Demographics
NPI:1215366471
Name:MYERS, ANNE MIRIAM (PC, CDCA)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MIRIAM
Last Name:MYERS
Suffix:
Gender:F
Credentials:PC, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 STONY POINT RD NW
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-7287
Mailing Address - Country:US
Mailing Address - Phone:330-243-1438
Mailing Address - Fax:
Practice Address - Street 1:6940 STONY POINT RD NW
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-7287
Practice Address - Country:US
Practice Address - Phone:330-243-1438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1200507101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional