MEDICARE: COLLEEN TEMAJ PEREZ

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
1	106S00000X	Behavior Technician		MO

General Provider Information

NPI Number	:	1851221410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN TEMAJ PEREZ

Provider Business Mailing Address
First Line	:	226 STONE CREEK VALLEY DR
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-5420
Country	:	US
Telephone Number	:	636-493-4716
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 STONE CREEK VALLEY DR
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-5420
Country	:	US
Telephone Number	:	636-777-0781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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Directions to “ COLLEEN TEMAJ PEREZ ” Practice Location

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