Provider Demographics
NPI:1043353758
Name:CHIEZA, MERCY (PSYD)
Entity type:Individual
Prefix:DR
First Name:MERCY
Middle Name:
Last Name:CHIEZA
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 1:6515 SANGER AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7813
Mailing Address - Country:US
Mailing Address - Phone:254-741-6004
Mailing Address - Fax:254-741-6009
Practice Address - Street 1:6515 SANGER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7813
Practice Address - Country:US
Practice Address - Phone:254-741-6004
Practice Address - Fax:254-741-6009
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25456103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist