Provider Demographics
NPI:1609667799
Name:PERDOMO, NOEMI CAMILLE (CPL)
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:CAMILLE
Last Name:PERDOMO
Suffix:
Gender:F
Credentials:CPL
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:CAMILLE
Other - Last Name:PERDOMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPL
Mailing Address - Street 1:URB LEVITTOWN LAKES AT 19 CALLE LILLIAM E
Mailing Address - Street 2:N.PERDONO@GMAIL.COM
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-0094
Mailing Address - Country:US
Mailing Address - Phone:787-462-1717
Mailing Address - Fax:
Practice Address - Street 1:URB LEVITTOWN LAKES AT 19 CALLE LILLIAM E
Practice Address - Street 2:N.PERDONO@GMAIL.COM
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-0094
Practice Address - Country:US
Practice Address - Phone:787-462-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional