Provider Demographics
NPI:1154540433
Name:MERRIFIELD, DEBRA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:L
Last Name:MERRIFIELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 W BELL RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3425
Mailing Address - Country:US
Mailing Address - Phone:029-420-2526
Mailing Address - Fax:602-938-6640
Practice Address - Street 1:4915 W BELL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:602-852-0911
Practice Address - Fax:602-938-6640
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1747103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1154540433OtherNPI
AZ1747OtherLICENSE