| Doctor Name: | MARILOURDES PEREZ |
| NPI Number: | 1124366430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., I.M.H |
| License Number: | IMH9868 |
| Business Practice Address: | 201 W Plymouth Ave Deland, FL - 327202753 |
| Business Phone Number: | 3868732963 |
| Business Fax Number: | 3868732786 |
| Mailing Address: | 201 W Plymouth Ave, DELAND |
| State: | FL |
| Postal Code: | 327202753 |
| Phone Number: | 3868732963 |
| Fax Number: | 3868732786 |
| NPI Enumeration Date: | 01/21/2013 |
| NPI Last Update Date: | 01/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMH9868 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |