Provider Demographics
NPI:1790235661
Name:PERRY, JOANNE E (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:E
Last Name:PERRY
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 HIERING AVE
Mailing Address - Street 2:
Mailing Address - City:SEASIDE HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08751-1703
Mailing Address - Country:US
Mailing Address - Phone:732-250-1242
Mailing Address - Fax:
Practice Address - Street 1:235 HIERING AVE
Practice Address - Street 2:
Practice Address - City:SEASIDE HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08751-1703
Practice Address - Country:US
Practice Address - Phone:732-250-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00567900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist