Individual
DANIELLA M MERZLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4460 CENTRAL WAY, STE 2, CHUBBUCK, ID 83202
(208) 237-1711
Mailing address
PO BOX 4908, POCATELLO, ID 83205-4908
(208) 237-1711
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-4867
ID
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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