Individual
KATHRYNE MERLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
197B E US HIGHWAY 40, TROY, IL 62294-2262
(618) 505-0784
(618) 505-0785
Mailing address
PO BOX 395, TROY, IL 62294-0395
(618) 505-0784
(618) 505-0785
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150107468
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150107468
LICENSED SOCIAL WORKER
IL
Enumeration date
06/22/2022
Last updated
06/22/2022
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