Provider Demographics
NPI:1558098657
Name:MERLO, ELIZABETH O'MEARA
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:O'MEARA
Last Name:MERLO
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 1:1954 GREENSPRING DR STE 530
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4192
Mailing Address - Country:US
Mailing Address - Phone:240-441-9858
Mailing Address - Fax:
Practice Address - Street 1:1954 GREENSPRING DR STE 530
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4192
Practice Address - Country:US
Practice Address - Phone:240-441-9858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22614104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker