Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003299348 |
---|---|
Provider Name | Merlyn Perez |
First Address | Merced, CA 95340-4438 |
Second Address | Merced, CA 95340-4438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2015 |
Last Update Date | 06/07/2015 |