Individual
JANE MARY MERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
850 BROADWAY ST, SEASIDE, OR 97138-6824
(419) 322-4450
Mailing address
3528 SUNSET BLVD, SEASIDE, OR 97138-5049
(419) 322-4450
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401012878
MI
101YP2500X
Professional Counselor
Primary
C3782
OR
Other
Enumeration date
02/06/2012
Last updated
07/09/2015
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