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Individual

MRS. LELIA MAE MERRILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
1218 HARRISON AVE, CENTRALIA, WA 98531-1853
(360) 807-0677
Mailing address
1218 HARRISON AVE, CENTRALIA, WA 98531-1853
(360) 807-0677

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MA00012496
WA

Other

Enumeration date
11/01/2007
Last updated
11/01/2007
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