Provider Demographics
NPI:1972661791
Name:PEREZ, MARIA ISABEL (MA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 VALENTINE ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3844
Mailing Address - Country:US
Mailing Address - Phone:860-930-5168
Mailing Address - Fax:
Practice Address - Street 1:80 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5035
Practice Address - Country:US
Practice Address - Phone:860-240-5688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health