Individual
REGINA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10201 W LINCOLN AVE, STE 102, WEST ALLIS, WI 53227-2136
(414) 546-6880
(414) 546-6891
Mailing address
10201 W LINCOLN AVE, STE 102, WEST ALLIS, WI 53227-2136
(414) 546-6880
(414) 546-6891
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14827-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14827-130
SAC-IT
WI
Enumeration date
01/30/2008
Last updated
01/30/2008
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