Healthcare Provider Details

I. General information

NPI: 1023156445
Provider Name (Legal Business Name): LAILA KATHERINE MERZ PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAILA MERZ PH.D

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9890 CLAYTON RD # 134
SAINT LOUIS MO
63124-1685
US

IV. Provider business mailing address

15455 MANCHESTER RD #3311
BALLWIN MO
63011-1546
US

V. Phone/Fax

Practice location:
  • Phone: 314-222-5852
  • Fax: 314-222-5853
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2001024795
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: