Individual
TIMOTHY C. MERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1405 SPRUCE ST, RIVERSIDE, CA 92507-2464
(951) 715-5050
Mailing address
1405 SPRUCE ST STE A, RIVERSIDE, CA 92507-2410
(951) 715-5050
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
02/06/2007
Last updated
07/29/2016
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