Provider Demographics
NPI:1841690013
Name:PERRY, MARIA (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TOWNSQUARE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2568
Mailing Address - Country:US
Mailing Address - Phone:862-242-0026
Mailing Address - Fax:
Practice Address - Street 1:5 TOWNSQUARE
Practice Address - Street 2:SUITE B
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2568
Practice Address - Country:US
Practice Address - Phone:862-242-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00529900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist