Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2001024795 | MO |
NPI | 1023156445 |
---|---|
Provider Name | Laila Katherine Merz |
First Address | Ballwin, MO 63011-1546 |
Second Address | Saint Louis, MO 63124-1685 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/01/2021 |