Provider Demographics
NPI:1760720775
Name:MKRTCHIAN, MERY
Entity Type:Individual
Prefix:MRS
First Name:MERY
Middle Name:
Last Name:MKRTCHIAN
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 1:402 EAST DRYDEN STREEST
Mailing Address - Street 2:#1
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207
Mailing Address - Country:US
Mailing Address - Phone:818-572-5971
Mailing Address - Fax:
Practice Address - Street 1:402 EAST DRYDEN ST
Practice Address - Street 2:#1
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207
Practice Address - Country:US
Practice Address - Phone:818-572-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst