Individual
MISS SARA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC
Contact information
Practice address
3351 CLAYSTONE ST SE STE 212, GRAND RAPIDS, MI 49546-5781
(616) 954-1991
(616) 233-0718
Mailing address
3351 CLAYSTONE ST SE STE 212, GRAND RAPIDS, MI 49546-5781
(616) 954-1991
(616) 233-0718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381359253
TAX ID #
MI
Enumeration date
10/06/2008
Last updated
10/06/2008
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