Provider Demographics
NPI:1164518304
Name:MERRITT, REBECCA ESTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ESTHER
Last Name:MERRITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:ESTHER
Other - Last Name:WOLLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:499 W. WASHINGTON AVE
Mailing Address - Street 2:#1197
Mailing Address - City:AVA
Mailing Address - State:MO
Mailing Address - Zip Code:65608
Mailing Address - Country:US
Mailing Address - Phone:417-686-1310
Mailing Address - Fax:816-922-3353
Practice Address - Street 1:221 N WALL ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0812
Practice Address - Country:US
Practice Address - Phone:206-910-9476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001678722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry