Provider Demographics
NPI:1326259409
Name:PEREZ HERNANDEZ, EVELYN (TRABAJADORA SOCIAL)
Entity Type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:
Last Name:PEREZ HERNANDEZ
Suffix:
Gender:F
Credentials:TRABAJADORA SOCIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#615 URB. PASEOS DE CAMUY
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-262-4907
Mailing Address - Fax:
Practice Address - Street 1:ANTIGUO SALUD MENTAL 2DO PISO CARR 129
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-262-4907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5420251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health