Provider Demographics
NPI:1922343383
Name:MCGULL, MERRILEE BETH (ABA THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:MERRILEE
Middle Name:BETH
Last Name:MCGULL
Suffix:
Gender:F
Credentials:ABA THERAPIST
Other - Prefix:MISS
Other - First Name:MERRILEE
Other - Middle Name:BETH
Other - Last Name:CRIPPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 MITHRA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-2018
Mailing Address - Country:US
Mailing Address - Phone:504-221-3982
Mailing Address - Fax:
Practice Address - Street 1:4301 N FEDERAL HWY
Practice Address - Street 2:SUITE #2
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6519
Practice Address - Country:US
Practice Address - Phone:954-603-7885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist