Provider Demographics
NPI:1629657846
Name:JERI, ANA PAULA P
Entity Type:Individual
Prefix:
First Name:ANA PAULA
Middle Name:P
Last Name:JERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 RENAISSANCE CT UNIT A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3932
Mailing Address - Country:US
Mailing Address - Phone:704-441-9177
Mailing Address - Fax:
Practice Address - Street 1:10516 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8405
Practice Address - Country:US
Practice Address - Phone:704-325-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst