Provider Demographics
NPI:1447623962
Name:LAMMERS, MERYL (MT-BC)
Entity type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:LAMMERS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-2943
Mailing Address - Country:US
Mailing Address - Phone:215-990-0362
Mailing Address - Fax:
Practice Address - Street 1:542 N PROVIDENCE ROAD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:215-990-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA07469225A00000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist