Individual
MRS. AMBER RENEA MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.C.B.A
Contact information
Practice address
107 MALLARD ST, LAKE CHARLES, LA 70605-6515
(337) 304-0891
Mailing address
PO BOX 91895, LAKE CHARLES, LA 70609-0001
(337) 562-4115
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-9579
LA
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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