Provider Demographics
NPI:1023632601
Name:MERRYFIELD, ELIZABETH ANN (PSYD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:MERRYFIELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:MERRYFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSD
Mailing Address - Street 1:1489 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3958
Mailing Address - Country:US
Mailing Address - Phone:610-544-2110
Mailing Address - Fax:
Practice Address - Street 1:1489 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3958
Practice Address - Country:US
Practice Address - Phone:610-544-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019033103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist