Provider Demographics
NPI:1093119463
Name:FELKER-MERRITT, DARA
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:FELKER-MERRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CHRISTINA ST
Mailing Address - Street 2:
Mailing Address - City:RAMEY
Mailing Address - State:PA
Mailing Address - Zip Code:16671
Mailing Address - Country:US
Mailing Address - Phone:814-215-2152
Mailing Address - Fax:
Practice Address - Street 1:135 CHRISTINA STREET
Practice Address - Street 2:
Practice Address - City:RAMEY
Practice Address - State:PA
Practice Address - Zip Code:16671
Practice Address - Country:US
Practice Address - Phone:814-215-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000470103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst