Individual
JACKY EILEEN MERGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
616 RENO ST, HAWLEY, MN 56549
(218) 483-5678
Mailing address
402 MAPLE ST., HAWLEY, MN 56549
(218) 486-5077
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
102599
MN
225XP0200X
Pediatric Occupational Therapist
Primary
816
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26623
BCBS ND PROVIDER NUMBER
ND
05
—
51032
—
ND
Enumeration date
01/12/2007
Last updated
02/02/2026
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