Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 3637 | AZ |
Y | 103G00000X | Clinical Psychologist | 3637 | AZ |
Y | 103TC0700X | Clinical Psychologist | 3637 | AZ |
NPI | 1174758254 |
---|---|
Provider Name | Dr. Gina Touch Mercer |
First Address | Anthem, AZ 85086-4915 |
Second Address | Anthem, AZ 85086-4915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 19/05/2009 |