Provider Demographics
NPI:1538496740
Name:PEREZ RAMIREZ, DAMARIS TERESA (MA LP LPC)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:TERESA
Last Name:PEREZ RAMIREZ
Suffix:
Gender:F
Credentials:MA LP LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:91 SNELLING AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6753
Mailing Address - Country:US
Mailing Address - Phone:952-215-4993
Mailing Address - Fax:651-642-5909
Practice Address - Street 1:91 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6753
Practice Address - Country:US
Practice Address - Phone:952-215-4993
Practice Address - Fax:651-642-5909
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00446101YP2500X
MN5169103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional