Provider Demographics
NPI:1316670482
Name:PEREZ, HAILEY KROUSE (PHD)
Entity type:Individual
Prefix:DR
First Name:HAILEY
Middle Name:KROUSE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 DWIGHT ROWLAND RD UNIT 621
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-0150
Mailing Address - Country:US
Mailing Address - Phone:919-704-4204
Mailing Address - Fax:
Practice Address - Street 1:3624 NORMAN BLALOCK RD
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-8966
Practice Address - Country:US
Practice Address - Phone:919-903-6209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4777103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist