| Doctor Name: | DR. EDWIN DEJ. PERRY JOSEPH |
| NPI Number: | 1457345266 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 004144 |
| Business Practice Address: | 44 Washington St Mystic, CT - 063552839 |
| Business Phone Number: | 8604156837 |
| Business Fax Number: | |
| Mailing Address: | Po Box 521, OLD MYSTIC |
| State: | CT |
| Postal Code: | 063720521 |
| Phone Number: | 8604156837 |
| Fax Number: | |
| NPI Enumeration Date: | 09/07/2005 |
| NPI Last Update Date: | 03/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 004144 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |