Provider Demographics
NPI:1477522274
Name:PEREZ CHEVERE, IVELISSE (PSY D)
Entity Type:Individual
Prefix:
First Name:IVELISSE
Middle Name:
Last Name:PEREZ CHEVERE
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SABANERA DEL RIO
Mailing Address - Street 2:256 HELECHOS
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0000
Mailing Address - Country:US
Mailing Address - Phone:787-653-6116
Mailing Address - Fax:787-653-6117
Practice Address - Street 1:33 CALLE RUIZ BELVIS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3784
Practice Address - Country:US
Practice Address - Phone:787-653-6116
Practice Address - Fax:787-653-6117
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1657103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist