Provider Demographics
NPI:1477910735
Name:DURAN, MERLIN (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:MERLIN
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 GLEN AUTUMN RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4831
Mailing Address - Country:US
Mailing Address - Phone:813-245-4123
Mailing Address - Fax:
Practice Address - Street 1:10120 GLEN AUTUMN RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4831
Practice Address - Country:US
Practice Address - Phone:813-245-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor