Provider Demographics
NPI:1750008736
Name:PEREZ, MILAGROS
Entity type:Individual
Prefix:
First Name:MILAGROS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MILAGROS
Other - Middle Name:
Other - Last Name:VAZQUEZ-FIGUEROA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4337 INDIANAPOLIS BLVD APT 2S
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-2627
Mailing Address - Country:US
Mailing Address - Phone:219-306-6745
Mailing Address - Fax:
Practice Address - Street 1:4337 INDIANAPOLIS BLVD APT 2S
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-2627
Practice Address - Country:US
Practice Address - Phone:219-306-6745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician