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Individual
DR. STEPHANIE ANN PEREZ
Active
Individual
DR. STEPHANIE ANN PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
012191
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040728-000-060
FIDELIS
NY
01
—
246-683
VALUE OPTIONS NUMBER
NY
01
—
688-5837
VALUE OPTIONS GHI PIN NUM
NY
01
—
S12191-3
WCB AUTH #
NY
Enumeration date
05/06/2007
Last updated
07/08/2007
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