Provider Demographics
NPI:1770099285
Name:VELEZ-PEREZ, CORAL ENID
Entity type:Individual
Prefix:
First Name:CORAL
Middle Name:ENID
Last Name:VELEZ-PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-1533
Mailing Address - Country:US
Mailing Address - Phone:939-332-4920
Mailing Address - Fax:
Practice Address - Street 1:443 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1533
Practice Address - Country:US
Practice Address - Phone:939-332-4920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health