Provider Demographics
NPI:1831641729
Name:PEREZ, VANESSA LIZ (BS)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LIZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 RUTA 9
Mailing Address - Street 2:BO. JOBOS
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 RUTA 9
Practice Address - Street 2:BO. JOBOS
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2197
Practice Address - Country:US
Practice Address - Phone:787-932-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR70362355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant