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1194261693 NPI number — KELLY PEREZ M.S. LBS BCBA

NPI Number: 1194261693
Health Care Provider/Practitioner: KELLY PEREZ M.S. LBS BCBA

Information about “1194261693” NPI (KELLY PEREZ M.S. LBS BCBA) exists in 1194261693 in HTML format HTML  |  1194261693 in plain Text format TXT  |  1194261693 in PDF (Portable Document Format) PDF  |  1194261693 in an XML format XML  formats.

NPI Number : 1194261693 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194261693",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PEREZ",
    "FirstName": "KELLY",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.S. LBS BCBA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RICH",
    "OtherFirstName": "KELLY",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "213 N STERLING ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALLENTOWN",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "18104-5140",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "610-442-8583",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "807 LAWN AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SELLERSVILLE",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "18960-1549",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "267-404-5988",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/09/2017",
    "LastUpdateDate": "01/10/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": "BH003213",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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