Provider Demographics
NPI:1740869692
Name:LE VITRE PEREZ, PAOLA G
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:G
Last Name:LE VITRE PEREZ
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 1:14021 PEBBLE HILLS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2851
Mailing Address - Country:US
Mailing Address - Phone:915-529-0701
Mailing Address - Fax:
Practice Address - Street 1:14021 PEBBLE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2850
Practice Address - Country:US
Practice Address - Phone:915-529-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician