Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1033721642 |
---|---|
Provider Name | Mrs. Maritza Perez |
First Address | Passaic, NJ 07055-5207 |
Second Address | Passaic, NJ 07055-5207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2020 |
Last Update Date | 17/08/2020 |