Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003295536 |
---|---|
Provider Name | Lianett Perez |
First Address | Miami, FL 33126-2079 |
Second Address | Miami, FL 33126-5473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2015 |
Last Update Date | 29/05/2015 |