Provider Demographics
NPI:1669844999
Name:PERRY, QUAVAUNDRA A (PHD, ABPP)
Entity type:Individual
Prefix:DR
First Name:QUAVAUNDRA
Middle Name:A
Last Name:PERRY
Suffix:
Gender:F
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 RIDGE RD STE 101
Mailing Address - Street 2:#562
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6612
Mailing Address - Country:US
Mailing Address - Phone:469-315-7475
Mailing Address - Fax:
Practice Address - Street 1:2931 RIDGE RD STE 101
Practice Address - Street 2:#562
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6612
Practice Address - Country:US
Practice Address - Phone:469-315-7475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37044103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling