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Individual
MISTY MAYLE
Active
Individual
MISTY MAYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2314525
—
OH
05
—
2864002
—
OH
Enumeration date
10/01/2018
Last updated
08/29/2019
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