Individual
MYRON PRIESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
460 BRIELLE AVE, STATEN ISLAND, NY 10314-1031
(718) 816-6589
(718) 816-1689
Mailing address
460 BRIELLE AVE, STATEN ISLAND, NY 10314-6427
(718) 816-6589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
35064
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35064
—
NY
Enumeration date
09/25/2019
Last updated
09/25/2019
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