Doctor Name: | MRS. TRACY ARNEL PEREZ |
NPI Number: | 1174679963 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 505 |
Business Practice Address: | 35401 Mission Drive St Ignatius, MT - 59865 |
Business Phone Number: | 4067453525 |
Business Fax Number: | 4067453529 |
Mailing Address: | P.o. Box 880, ST. IGNATIUS |
State: | MT |
Postal Code: | 59865 |
Phone Number: | 4067453525 |
Fax Number: | 4067453529 |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 01/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |