Provider Demographics
NPI:1710611215
Name:PEREZ OLGUIN, SAUL (LLMSW)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:PEREZ OLGUIN
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 COMPANY ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2007
Mailing Address - Country:US
Mailing Address - Phone:773-559-7420
Mailing Address - Fax:
Practice Address - Street 1:115 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2019
Practice Address - Country:US
Practice Address - Phone:734-707-8377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851109279104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker