Provider Demographics
NPI:1811557564
Name:MERKLE, DARLA (RBT)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:MERKLE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8960 N ONYX ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9415
Mailing Address - Country:US
Mailing Address - Phone:520-302-1159
Mailing Address - Fax:
Practice Address - Street 1:3490 N PASEO DE SAN AGUSTIN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6035
Practice Address - Country:US
Practice Address - Phone:855-462-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-15
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-19-89515106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician