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General NPI Number Information
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NPI Number | 1528786969
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Entity Type | Individual
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Provider Name | JESENIA PEREZ MSW
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 819 NE 26TH ST
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City | WILTON MANORS
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State | FL
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Zip | 33305-1239
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Country | US
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Telephone | 754-800-3817
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Fax |
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Provider Business Mailing Address
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Address Line | 2324 S CYPRESS BEND DR APT 217
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City | POMPANO BEACH
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State | FL
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Zip | 33069-5656
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Country | US
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Telephone | 954-371-9198
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | FL
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