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General NPI Number Information
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NPI Number | 1336915669
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Entity Type | Organization
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Legal Business Name | PEREZ THERAPY, LLC
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 112 E ALLEN ST UNIT 3
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City | PHILADELPHIA
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State | PA
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Zip | 19125-4189
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Country | US
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Telephone | 215-278-9444
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Fax | 484-930-0829
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Provider Business Mailing Address
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Address Line | 112 E ALLEN ST UNIT 3
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City | PHILADELPHIA
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State | PA
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Zip | 19125-4189
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Country | US
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Telephone | 215-278-9444
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Fax | 484-930-0829
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Authorized Official
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Title or Position | CEO
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Name | FELIX ALEXANDER PEREZ
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Credential | LCSW
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Telephone | 215-554-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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