Individual
CHRISTINE MEROLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231-1525
(434) 923-4476
(443) 923-4403
Mailing address
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231-1525
(434) 923-4476
(443) 923-4403
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
06117
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01536011
MEDI-CAL
CA
Enumeration date
11/21/2014
Last updated
03/11/2022
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