Provider Demographics
NPI:1043714827
Name:MYERS, AARON (PSYD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-0864
Mailing Address - Country:US
Mailing Address - Phone:610-530-8392
Mailing Address - Fax:
Practice Address - Street 1:726 CHURCH ST
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-0864
Practice Address - Country:US
Practice Address - Phone:610-530-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018748103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist