| Doctor Name: | MISS MERRY CATHERINE ROSE EVERSOLE |
| NPI Number: | 1073713608 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.-CCC-SLP |
| License Number: | |
| Business Practice Address: | 802 E Hwy 20 Michigan City, IN - 46360 |
| Business Phone Number: | 2198613121 |
| Business Fax Number: | |
| Mailing Address: | 5858 Demorrow Road, STEVENSVILLE |
| State: | MI |
| Postal Code: | 49127 |
| Phone Number: | 2085233662 |
| Fax Number: | 2085236002 |
| NPI Enumeration Date: | 07/22/2007 |
| NPI Last Update Date: | 01/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |