Provider Demographics
NPI:1407698079
Name:PEREZ, RITA ANNE
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:ANNE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:ANNE
Other - Last Name:DEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15012 MISSION SQ APT 1222
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-5333
Mailing Address - Country:US
Mailing Address - Phone:765-969-3111
Mailing Address - Fax:
Practice Address - Street 1:7001 HOOVER RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-4169
Practice Address - Country:US
Practice Address - Phone:317-251-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist