Provider Demographics
NPI:1538459417
Name:PEREZ, STEPHANIE KATHERINE (MOT, OTR)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:KATHERINE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 LUBRANO DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7568
Mailing Address - Country:US
Mailing Address - Phone:571-379-1242
Mailing Address - Fax:
Practice Address - Street 1:129 LUBRANO DR STE 301
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7568
Practice Address - Country:US
Practice Address - Phone:571-379-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09456225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand