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NPI Code Detail

MEDICARE: KIMBERLY PEREZ

MEDICARE: KIMBERLY PEREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst0-24-15032SC
2106S00000XBehavior TechnicianRBT-20-109697SC
3103K00000XBehavior Analyst1-25-82515SC

General Provider Information

NPI Number : 1962175406
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY PEREZ
Provider Business Mailing Address
First Line : 120 BROADUS AVE
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3040
Country : US
Telephone Number : 864-752-9123
Fax Number :
Provider Business Practice Location Address
First Line : 120 BROADUS AVE
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3040
Country : US
Telephone Number : 864-752-9123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2021
Last Update Date : 07/28/2025

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Directions to “ KIMBERLY PEREZ ” Practice Location

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