Provider Demographics
NPI:1013213685
Name:PEREZ, GLENDA YARILIZ (SLP)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:YARILIZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POBOX 6461
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-6461
Mailing Address - Country:US
Mailing Address - Phone:787-315-8899
Mailing Address - Fax:
Practice Address - Street 1:URB PEREZ MORRIS CALLE PONCE EXT CALLE BAEZ
Practice Address - Street 2:HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-767-6710
Practice Address - Fax:787-758-0950
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR983235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist