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Individual
MARK DUANE MERRICK
Active
Individual
MARK DUANE MERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LMFT80920
CA
101YM0800X
Mental Health Counselor
Primary
T1064
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMFT80920
LMFT
CA
01
—
T1064
LMFT
OR
Enumeration date
10/11/2017
Last updated
10/11/2017
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