Individual
VIVIAN PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1 BOSTON MEDICAL CENTER PLACE, BOSTON, MA 02118
(617) 414-5245
(617) 638-6836
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7058
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110088943A
—
MA
Enumeration date
03/09/2007
Last updated
12/27/2017
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