Individual
MERINELL E THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 283-1107
(574) 283-1131
Mailing address
4335 IRISH HILLS DR APT 1C, SOUTH BEND, IN 46614-3110
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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