Provider Demographics
NPI:1013497932
Name:PERRY, MONICA YVETTE (COTA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:YVETTE
Last Name:PERRY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 FM 1794 W
Mailing Address - Street 2:
Mailing Address - City:BECKVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75631-5144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1154 E HAWKINS PKWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-7975
Practice Address - Country:US
Practice Address - Phone:903-663-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation