Individual
INMACULADA C PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3803-05 N 5TH, PHILADELPHIA, PA 19140
(215) 539-2473
Mailing address
5319 CASTOR AVE, PHILADELPHIA, PA 19124-1022
(215) 869-9094
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01
MEDICARE
PA
01
—
2ERKP
YES
PA
Enumeration date
02/21/2022
Last updated
02/21/2022
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