Healthcare Provider Details

I. General information

NPI: 1306510466
Provider Name (Legal Business Name): OLINDA PATRICIA PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 N OAKLAND BLVD
WATERFORD MI
48327-1549
US

IV. Provider business mailing address

32100 TELEGRAPH RD STE 205
BINGHAM FARMS MI
48025-2454
US

V. Phone/Fax

Practice location:
  • Phone: 248-599-8999
  • Fax:
Mailing address:
  • Phone: 248-712-4266
  • Fax: 248-712-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: