Provider Demographics
NPI:1588062210
Name:PERMAN, HUAN JACQUELINE (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:HUAN
Middle Name:JACQUELINE
Last Name:PERMAN
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:HUAN
Other - Middle Name:JACQUELINE
Other - Last Name:YE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:1616 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1521
Mailing Address - Country:US
Mailing Address - Phone:352-872-8669
Mailing Address - Fax:
Practice Address - Street 1:827 1/2 BROAD ST APT 1
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2145
Practice Address - Country:US
Practice Address - Phone:352-872-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019552103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist