Provider Demographics
NPI:1619051927
Name:CABALLERO, MERCE (PHD)
Entity Type:Individual
Prefix:
First Name:MERCE
Middle Name:
Last Name:CABALLERO
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 1:716 WINDINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-9504
Mailing Address - Country:US
Mailing Address - Phone:513-523-2013
Mailing Address - Fax:
Practice Address - Street 1:115 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1721
Practice Address - Country:US
Practice Address - Phone:513-523-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4805103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist