Provider Demographics
NPI:1376333039
Name:MERRY, GENEVIEVE MAE
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:MAE
Last Name:MERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 PENNYSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5767
Mailing Address - Country:US
Mailing Address - Phone:512-635-0997
Mailing Address - Fax:
Practice Address - Street 1:3326 ASPEN GROVE DR STE 604
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-4858
Practice Address - Country:US
Practice Address - Phone:629-236-4547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician