Individual
DR. SUSAN J. PERRY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.,CDC
Contact information
Practice address
620 CORONADO AVE, ESPANOLA, NM 87532-2725
(505) 753-7395
(505) 753-8373
Mailing address
111 N RAILROAD AVE, P.O. BOX 158, ESPANOLA, NM 87532-2627
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2874
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73812
—
NM
Enumeration date
08/31/2005
Last updated
07/09/2007
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