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General NPI Number Information
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NPI Number | 1649728718
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Entity Type | Individual
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Provider Name | CORRINNE MERCER BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 10338 E 11TH ST STE 105
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City | TULSA
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State | OK
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Zip | 74128-3008
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Country | US
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Telephone | 918-601-5676
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Fax |
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Provider Business Mailing Address
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Address Line | 5517 BROOKSIDE DR
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City | ARGYLE
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State | TX
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Zip | 76226-2239
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Country | US
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Telephone | 940-363-9788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-16-22938
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1292
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License Number State | TX
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