Provider Demographics
NPI:1417706896
Name:MYERS, LAUREN M
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
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 1:29875 W 339TH ST
Mailing Address - Street 2:
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-4159
Mailing Address - Country:US
Mailing Address - Phone:866-489-8799
Mailing Address - Fax:
Practice Address - Street 1:29875 W 339TH ST
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-4159
Practice Address - Country:US
Practice Address - Phone:866-489-8799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician