Individual
SOPHIA KALYNN PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
201 HIGHLAND DR, ZILLAH, WA 98953-9716
(509) 865-6705
(509) 865-2011
Mailing address
201 HIGHLAND DRIVE, BUENA, WA 98921
(509) 865-6705
(509) 865-5011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PEREZSK075D7
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-0755984
—
WA
Enumeration date
11/06/2018
Last updated
11/06/2018
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