Provider Demographics
NPI:1174758254
Name:MERCER, GINA TOUCH (PHD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:TOUCH
Last Name:MERCER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 W WAYNE LN
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4915
Mailing Address - Country:US
Mailing Address - Phone:623-399-7935
Mailing Address - Fax:623-551-8621
Practice Address - Street 1:2665 W WAYNE LN
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-4915
Practice Address - Country:US
Practice Address - Phone:623-399-7935
Practice Address - Fax:623-551-8621
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3637103TA0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging