Provider Demographics
NPI:1518313105
Name:PEREZ, TATTIANA Y (BS)
Entity Type:Individual
Prefix:MISS
First Name:TATTIANA
Middle Name:Y
Last Name:PEREZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 SOUTHERN BREEZE LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-5095
Mailing Address - Country:US
Mailing Address - Phone:732-527-7769
Mailing Address - Fax:
Practice Address - Street 1:195 SOUTHERN BREEZE LOOP
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-5095
Practice Address - Country:US
Practice Address - Phone:732-527-7769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI38032355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant