Provider Demographics
NPI:1366183527
Name:MYERS-BUSCH, KARICE ELIZABETH
Entity type:Individual
Prefix:
First Name:KARICE
Middle Name:ELIZABETH
Last Name:MYERS-BUSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1633
Mailing Address - Country:US
Mailing Address - Phone:612-281-5143
Mailing Address - Fax:
Practice Address - Street 1:427 WEST TRAVELERS TRAIL
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55377
Practice Address - Country:US
Practice Address - Phone:952-247-2954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician