=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093475428
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. NATALIE S MERCER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2021
-----------------------------------------------------
Last Update Date | 12/27/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3703 OAKWOOD HILLS PKWY STE 100
-----------------------------------------------------
City | EAU CLAIRE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54701-4458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 534-444-4562
-----------------------------------------------------
Fax | 534-444-4563
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2407 KNAPP ST
-----------------------------------------------------
City | MENOMONIE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54751-1206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-505-6594
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 805-228
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------