Provider Demographics
NPI:1114760741
Name:PEREZ, DEVON
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 CONTANT AVE APT 8A
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1722
Mailing Address - Country:US
Mailing Address - Phone:201-562-5876
Mailing Address - Fax:
Practice Address - Street 1:86 CONTANT AVE APT 8A
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1722
Practice Address - Country:US
Practice Address - Phone:201-562-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist