Provider Demographics
NPI:1265611859
Name:MERINO, HJALMAR
Entity type:Individual
Prefix:MR
First Name:HJALMAR
Middle Name:
Last Name:MERINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:MESCALERO
Mailing Address - State:NM
Mailing Address - Zip Code:88340-0311
Mailing Address - Country:US
Mailing Address - Phone:575-937-4550
Mailing Address - Fax:
Practice Address - Street 1:249 WHITE MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:MESCALERO
Practice Address - State:NM
Practice Address - Zip Code:88340-9622
Practice Address - Country:US
Practice Address - Phone:575-937-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool