| Doctor Name: | MIKEL M MERRITT |
| NPI Number: | 1427158203 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | NOT OBTAINED |
| Business Practice Address: | 200 First St Holloman Afb, NM - 88330 |
| Business Phone Number: | 5055725676 |
| Business Fax Number: | |
| Mailing Address: | 2729 Socorro Loop Apt B, HOLLOMAN AFB |
| State: | NM |
| Postal Code: | 883307124 |
| Phone Number: | 5055725676 |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | NOT OBTAINED |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |