Provider Demographics
NPI:1043762826
Name:PEREZ, CHRISTINA (RBT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 AIRPORTAVE BLDG D
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471
Mailing Address - Country:US
Mailing Address - Phone:281-239-1435
Mailing Address - Fax:281-239-0828
Practice Address - Street 1:4910 AIRPORT AVE STE F
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5759
Practice Address - Country:US
Practice Address - Phone:281-239-1435
Practice Address - Fax:281-239-0828
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15-01230106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician