| Doctor Name: | CYGRID KRISTIE PEREZ |
| NPI Number: | 1104299478 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 34005956A |
| Business Practice Address: | 245 W Johnson Rd Suite 9 La Porte, IN - 463502026 |
| Business Phone Number: | 2198090333 |
| Business Fax Number: | 2198090334 |
| Mailing Address: | 245 W Johnson Rd, Suite 9 LA PORTE |
| State: | IN |
| Postal Code: | 463502026 |
| Phone Number: | 2198090333 |
| Fax Number: | 2198090334 |
| NPI Enumeration Date: | 11/08/2015 |
| NPI Last Update Date: | 11/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34005956A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |