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General NPI Number Information
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NPI Number | 1740045186
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Entity Type | Organization
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Legal Business Name | DARLENE AVILES PEREZ
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 9809 N DELAWARE DRIVE
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City | BANGOR
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State | PA
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Zip | 18013
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Country | US
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Telephone | 484-868-9926
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Fax |
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Provider Business Mailing Address
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Address Line | 2430 BUTLER ST STE 369
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City | EASTON
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State | PA
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Zip | 18042-5303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LMFT, LICENSED FAMILY THERAPIST
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Name | DARLENE AVILES PEREZ
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Credential | MA
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Telephone | 484-868-9926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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