Provider Demographics
NPI:1982716429
Name:MERRELL, LAUREN ROSE (BS, BHRS, CM C/A/F)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ROSE
Last Name:MERRELL
Suffix:
Gender:F
Credentials:BS, BHRS, CM C/A/F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E BEECH AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-4711
Mailing Address - Country:US
Mailing Address - Phone:405-388-2133
Mailing Address - Fax:
Practice Address - Street 1:200 N CHOCTAW AVE
Practice Address - Street 2:SUITE NUMBER 140
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2624
Practice Address - Country:US
Practice Address - Phone:405-262-3209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health