Provider Demographics
NPI:1023156445
Name:MERZ, LAILA KATHERINE (PHD)
Entity type:Individual
Prefix:
First Name:LAILA
Middle Name:KATHERINE
Last Name:MERZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LAILA
Other - Middle Name:
Other - Last Name:MERZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:15455 MANCHESTER RD
Mailing Address - Street 2:#3311
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-1546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9890 CLAYTON RD # 134
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1685
Practice Address - Country:US
Practice Address - Phone:314-222-5852
Practice Address - Fax:314-222-5853
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001024795103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral