Provider Demographics
NPI:1518743798
Name:MERRILL, AZAH AMIR
Entity Type:Individual
Prefix:
First Name:AZAH
Middle Name:AMIR
Last Name:MERRILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 CHURCHILL CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1612
Mailing Address - Country:US
Mailing Address - Phone:864-349-8233
Mailing Address - Fax:
Practice Address - Street 1:1990 AUGUSTA ST STE 2500
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-6510
Practice Address - Country:US
Practice Address - Phone:864-370-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist