Provider Demographics
NPI:1235890757
Name:PEREZ, EDNA (RBT)
Entity Type:Individual
Prefix:
First Name:EDNA
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 1:108B WERT AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-4530
Mailing Address - Country:US
Mailing Address - Phone:609-227-7307
Mailing Address - Fax:
Practice Address - Street 1:50 MILLSTONE RD STE 201
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1415
Practice Address - Country:US
Practice Address - Phone:609-392-4900
Practice Address - Fax:609-392-5621
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician