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General NPI Number Information
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NPI Number | 1659991537
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Entity Type | Individual
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Provider Name | MISS CARLYE GAIL MERCER
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Gender | Female
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 5955 W MAIN ST STE 221
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City | KALAMAZOO
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State | MI
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Zip | 49009-9263
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Country | US
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Telephone | 269-400-5069
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Fax |
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Provider Business Mailing Address
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Address Line | 5258 STONEY BROOK RD
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City | KALAMAZOO
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State | MI
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Zip | 49009-3848
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Country | US
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Telephone | 269-400-5069
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101007265
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License Number State | MI
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