Provider Demographics
NPI:1912617556
Name:ENGLE, MERYL (MA)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:ENGLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MERYL
Other - Middle Name:
Other - Last Name:FELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7048 STARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4412
Mailing Address - Country:US
Mailing Address - Phone:258-951-6207
Mailing Address - Fax:
Practice Address - Street 1:2330 PASEO DEL PRADO
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4359
Practice Address - Country:US
Practice Address - Phone:725-204-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist