| Mariela Jazmin Soto, PSYD | |
| 
					2817 Rock Merritt Ave, Fort Liberty, NC 28310-2003  | |
| (419) 405-3191 | |
| Not Available | 
| Full Name | Mariela Jazmin Soto | 
|---|---|
| Gender | Female | 
| Speciality | Psychologist - Clinical | 
| Location | 2817 Rock Merritt Ave, Fort Liberty, North Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1073981577 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810007552 (Virginia) | Primary | 
| Entity Name | Merion Square Road Medical Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1942923123 PECOS PAC ID: 0446605422 Enrollment ID: O20240702003759  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mariela Jazmin Soto, PSYD 92-1118 Olani St Apt 1, Kapolei, HI 96707-4223 Ph: (419) 405-3191  | Mariela Jazmin Soto, PSYD 2817 Rock Merritt Ave, Fort Liberty, NC 28310-2003 Ph: (419) 405-3191  | 
Dr. Glen Stuart Fisher, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave Womack Army Medical Center, Fort Liberty, NC 28310 Phone: 910-907-8922 Fax: 910-907-6069  | |
Dr. Marielsy Esther Pimentel, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2817 S Rock Meritt Road, Fort Liberty, NC 28310 Phone: 910-907-6630  | |
Xacasia Ann Asuncion Evans, PSY.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave Womack Army Medical Center, Fort Liberty, NC 28310 Phone: 910-907-8922 Fax: 910-907-6069  | |
Julie Catherine Lee, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Road Building 4-3219, Fort Liberty, NC 28310 Phone: 910-570-3048  | |
Dr. Arthur Lloyd Miller, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave Womack Army Medical Center, Fort Liberty, NC 28310 Phone: 509-109-0782 Fax: 910-907-6069  | |
Casey Nelson, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave, Fort Liberty, NC 28310 Phone: 910-907-8922 Fax: 910-907-6069  |