Individual
MR. MYLES LAMONT EASLEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
583 SOUTHLAKE BLVD STE B, NORTH CHESTERFIELD, VA 23236-3096
(804) 594-6142
Mailing address
583 SOUTHLAKE BLVD STE B, NORTH CHESTERFIELD, VA 23236-3096
(804) 594-6142
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174502029
—
VA
Enumeration date
04/10/2012
Last updated
01/26/2018
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