Provider Demographics
NPI:1144219882
Name:MERZ, GEORGIA ANN (MA)
Entity Type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:ANN
Last Name:MERZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S 73RD PL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-1108
Mailing Address - Country:US
Mailing Address - Phone:480-985-7888
Mailing Address - Fax:480-985-7888
Practice Address - Street 1:1855 E SOUTHERN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5241
Practice Address - Country:US
Practice Address - Phone:602-571-3665
Practice Address - Fax:480-813-4721
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC0521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health