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General NPI Number Information
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NPI Number | 1477234599
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Entity Type | Individual
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Provider Name | MRS. SOPHIA M PEREZ
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Gender | Female
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 2399 E WALTON BLVD
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City | AUBURN HILLS
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State | MI
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Zip | 48326-1955
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Country | US
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Telephone | 248-475-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 681 SUNDIAL CIR
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City | INDIANAPOLIS
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State | IN
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Zip | 46231-1194
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Country | US
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Telephone | 517-214-5089
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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