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General NPI Number Information
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NPI Number | 1942797865
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Entity Type | Individual
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Provider Name | ROSA ALBA PEREZ
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Gender | Female
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 71 RAYMOND RD
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2211
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Country | US
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Telephone | 203-232-4398
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Fax |
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Provider Business Mailing Address
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Address Line | 302 CITY HILL ST
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City | NAUGATUCK
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State | CT
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Zip | 06770-3335
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Country | US
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Telephone | 347-798-5786
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1797
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License Number State | CT
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