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NPI Code Detail

MEDICARE: CORINNE AMBER PEREZ MA, LAC, CRC

MEDICARE: CORINNE AMBER PEREZ MA, LAC, CRC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLAC-17233AZ

General Provider Information

NPI Number : 1770120131
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORINNE AMBER PEREZ MA, LAC, CRC
Provider Business Mailing Address
First Line : 3131 N COUNTRY CLUB RD STE 100
Second Line :
City : TUCSON
State : AZ
Zip : 85716-1650
Country : US
Telephone Number : 520-229-6220
Fax Number : 520-544-3033
Provider Business Practice Location Address
First Line : 3131 N COUNTRY CLUB RD STE 100
Second Line :
City : TUCSON
State : AZ
Zip : 85716-1650
Country : US
Telephone Number : 520-229-6220
Fax Number : 520-544-3033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2019
Last Update Date : 12/04/2019

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