Individual
JISSELI PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
329 E 149TH ST FL 4, BRONX, NY 10451
(646) 666-3088
Mailing address
627 WALES AVE APT 3A, BRONX, NY 10455-3247
(917) 513-5445
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/17/2018
Last updated
05/19/2018
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