Provider Demographics
NPI:1093248874
Name:MERINO, TRACY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:
Last Name:MERINO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 MEDITERRANEAN DR STE 405
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-5623
Mailing Address - Country:US
Mailing Address - Phone:972-895-2609
Mailing Address - Fax:469-301-1308
Practice Address - Street 1:6675 MEDITERRANEAN DR STE 405
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-5623
Practice Address - Country:US
Practice Address - Phone:972-895-2609
Practice Address - Fax:469-301-1308
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37222103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist