Doctor Name: | MRS. KAYLA RENEE PEREZ |
NPI Number: | 1154637411 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BSW, MS |
License Number: | |
Business Practice Address: | 115 1/2 East First Street Watonga, OK - 737720000 |
Business Phone Number: | 5807749105 |
Business Fax Number: | 5805474076 |
Mailing Address: | 115 1/2 East First Street, WATONGA |
State: | OK |
Postal Code: | 737720000 |
Phone Number: | 5807749105 |
Fax Number: | 5805474076 |
NPI Enumeration Date: | 08/25/2010 |
NPI Last Update Date: | 08/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |