Provider Demographics
NPI:1649591025
Name:PERRY, MONICA YVETTE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:YVETTE
Last Name:PERRY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:YVETTER
Other - Last Name:BAEZ-PERRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:165 SABAL PALM DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-2591
Mailing Address - Country:US
Mailing Address - Phone:386-473-2953
Mailing Address - Fax:407-869-1006
Practice Address - Street 1:165 SABAL PALM DR STE 101
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-2591
Practice Address - Country:US
Practice Address - Phone:386-473-2953
Practice Address - Fax:407-869-1006
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-19
Last Update Date:2010-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist