Individual
COURTNIE MERRILL-PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 CASTING CT, TAYLORS, SC 29687-5766
(801) 625-3700
Mailing address
8 CASTING CT, TAYLORS, SC 29687-5766
(801) 625-3700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
10430686-3502
UT
1041C0700X
Clinical Social Worker
Primary
15432
SC
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055266
MEDICARE PIN
UT
01
—
260022408
RAILROAD MEDICARE
UT
05
—
8760003008007
—
UT
Enumeration date
09/09/2016
Last updated
10/30/2022
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