Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003111402 |
---|---|
Provider Name | Charnette Merritt |
First Address | Gainesville, FL 32608-4006 |
Second Address | Gainesville, FL 32608-4006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2011 |
Last Update Date | 14/12/2015 |