Most Relevant Information
Provider Data
| NPI Number: | 1003378100 |
| Provider Name: | ANGELA NICOLE MYRICK |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: | 001030 |
Most Important Dates
| Enumeration Date: | 04/05/2019 |
| Last Updated: | 04/05/2019 |
Provider Practice Location
1117 EUCLID AVE
LORAIN
OH
440522703
Practice Location Phone/Fax
| Phone: | 4407529806 |
| Fax: |
Provider Mailing Location
1117 EUCLID AVE
LORAIN
OH
440522703
Provider Mailing Phone/Fax
| Phone: | 4407529806 |
| Fax: |