| Doctor Name: | JANE MARY MERRILL |
| NPI Number: | 1144592148 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 6401012878 |
| Business Practice Address: | 850 Broadway St Seaside, OR - 971386824 |
| Business Phone Number: | 4193224450 |
| Business Fax Number: | |
| Mailing Address: | 3528 Sunset Blvd, SEASIDE |
| State: | OR |
| Postal Code: | 971385049 |
| Phone Number: | 4193224450 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2012 |
| NPI Last Update Date: | 07/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401012878 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |