Provider Demographics
NPI:1417665837
Name:PEREZ, SENTA (R-DMT, LCAT)
Entity Type:Individual
Prefix:
First Name:SENTA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:R-DMT, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 TROUTMAN ST APT 122
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-6199
Mailing Address - Country:US
Mailing Address - Phone:929-271-5208
Mailing Address - Fax:
Practice Address - Street 1:114 TROUTMAN ST APT 122
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-6199
Practice Address - Country:US
Practice Address - Phone:929-271-5208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00246101225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist