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General NPI Number Information
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NPI Number | 1750093415
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Entity Type | Individual
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Provider Name | JESSY KILLARI PEREZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 5635 W FORT ST
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City | DETROIT
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State | MI
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Zip | 48209-3154
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Country | US
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Telephone | 313-644-1500
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Fax | 313-849-0824
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Provider Business Mailing Address
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Address Line | 555 TOWNER ST
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City | YPSILANTI
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State | MI
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Zip | 48198-5723
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Country | US
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Telephone | 734-544-3050
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Fax | 734-544-7732
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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 | 6801119642
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License Number State | MI
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