| Doctor Name: | DR. RAYMOND JUSTIN MYLES |
| NPI Number: | 1073970547 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 571 |
| Business Practice Address: | 609a Warrior Road Fort Riley, KS - 66442 |
| Business Phone Number: | 7852407090 |
| Business Fax Number: | |
| Mailing Address: | 609 A Warrior Road, FORT RILEY |
| State: | KS |
| Postal Code: | 66442 |
| Phone Number: | 7852407090 |
| Fax Number: | |
| NPI Enumeration Date: | 01/28/2016 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 571 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |