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General NPI Number Information
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NPI Number | 1801634449
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Entity Type | Individual
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Provider Name | MARILENIS PEREZ
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Gender | Female
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 621 DEXTER ST
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City | CENTRAL FALLS
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State | RI
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Zip | 02863-2742
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Country | US
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Telephone | 401-346-6626
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Fax |
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Provider Business Mailing Address
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Address Line | 132 LENOX AVE
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City | PROVIDENCE
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State | RI
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Zip | 02907-2104
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Country | US
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Telephone | 401-346-6626
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 224Z00000X
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA01300
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License Number State | RI
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