Individual
ANGELA MAKEBA MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISCW
Contact information
Practice address
393 DUNLAP ST N STE 736, SAINT PAUL, MN 55104-4205
(612) 289-5656
(651) 925-0278
Mailing address
393 DUNLAP ST N STE 736, SAINT PAUL, MN 55104-4205
(612) 289-5656
(651) 925-0278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24391
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780011510
NPI
MN
01
—
46-3824598
TAX ID
MN
Enumeration date
01/23/2018
Last updated
01/23/2018
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