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Individual

KARINA A MERLOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6836 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 927-4100
(479) 927-4101
Mailing address
6836 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 927-4100
(479) 927-4101

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
237273795
MEDICAID PIN
AR
05
237291706
AR
Enumeration date
11/19/2020
Last updated
11/19/2020
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