Healthcare Provider Details

I. General information

NPI: 1154540433
Provider Name (Legal Business Name): DEBRA L MERRIFIELD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 W BELL RD SUITE 202
GLENDALE AZ
85308
US

IV. Provider business mailing address

4915 W BELL RD SUITE 202
GLENDALE AZ
85308-3425
US

V. Phone/Fax

Practice location:
  • Phone: 602-852-0911
  • Fax: 602-938-6640
Mailing address:
  • Phone: 29-420-2526
  • Fax: 602-938-6640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1747
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: