Provider Demographics
NPI:1982431508
Name:PEREZ, DAWN ELLEN (MA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ELLEN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 OAK ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-2440
Mailing Address - Country:US
Mailing Address - Phone:860-502-2022
Mailing Address - Fax:
Practice Address - Street 1:369 OAK ST
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-2440
Practice Address - Country:US
Practice Address - Phone:860-502-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor