Healthcare Provider Details

I. General information

NPI: 1790334027
Provider Name (Legal Business Name): AYANA MARIE PEREZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 9120
CHELSEA MA
02150-9120
US

IV. Provider business mailing address

PO BOX 9120
CHELSEA MA
02150-9120
US

V. Phone/Fax

Practice location:
  • Phone: 844-843-7279
  • Fax: 720-513-5762
Mailing address:
  • Phone: 844-843-7279
  • Fax: 720-513-5762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: