Provider Demographics
NPI:1255096517
Name:PEREZ RIVERA, VALERIE ENID
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:ENID
Last Name:PEREZ RIVERA
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:HC 4 BOX 46668
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-9015
Mailing Address - Country:US
Mailing Address - Phone:787-590-9262
Mailing Address - Fax:
Practice Address - Street 1:BO BAYAMONCITO SECTOR LAS CRUCES
Practice Address - Street 2:CARRETERA 787 KM 5 HM 8
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-590-9262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty