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General NPI Number Information
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NPI Number | 1073379293
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Entity Type | Organization
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Legal Business Name | PEREZ NEUROPSYCHOLOGY
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2355 HIGHWAY 36 W STE 400
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City | ROSEVILLE
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 612-460-1597
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Fax | 855-708-5583
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Provider Business Mailing Address
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Address Line | 2355 HIGHWAY 36 W STE 400
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City | ROSEVILLE
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 612-460-1597
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Fax | 855-708-5583
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Authorized Official
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Title or Position | BOARD-CERTIFIED NEUROPSYCHOLOGIST
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Name | DR. LESLIE N PEREZ
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Credential | PSYD, ABPP-CN
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Telephone | 612-460-1597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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