Provider Demographics
NPI:1003694837
Name:PEREIRA, JEWEL
Entity Type:Individual
Prefix:
First Name:JEWEL
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEWEL
Other - Middle Name:
Other - Last Name:WLAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF SOCIAL WORK- BHWTP2
Mailing Address - Street 2:GRADUATE SOCIAL WORK, BUCHANNAN HALL, SUITE 124
Mailing Address - City:NORMAL
Mailing Address - State:AL
Mailing Address - Zip Code:35762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4900 MERIDIAN ST NW DEPT OF
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:AL
Practice Address - Zip Code:35762-7500
Practice Address - Country:US
Practice Address - Phone:611-299-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker