| Doctor Name: | ELISABETH MERRELL |
| NPI Number: | 1033329321 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RDT# 298 |
| Business Practice Address: | 15 Fleming Rd Cranston, RI - 029203057 |
| Business Phone Number: | 8004558839 |
| Business Fax Number: | 8664558839 |
| Mailing Address: | 687 Highland Ave, Suite 16 NEEDHAM |
| State: | MA |
| Postal Code: | 024942232 |
| Phone Number: | 8004558726 |
| Fax Number: | 8664558839 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | RDT# 298 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |