Healthcare Provider Details

I. General information

NPI: 1316801913
Provider Name (Legal Business Name): KRISTINE ELIZABETH MERCKX RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 PATRIOT WAY
EASTAMPTON TOWNSHIP NJ
08060-9624
US

IV. Provider business mailing address

365 HEATHER DR N
MANTUA NJ
08051-1819
US

V. Phone/Fax

Practice location:
  • Phone: 856-492-1355
  • Fax:
Mailing address:
  • Phone: 609-221-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: