Provider Demographics
NPI:1780022145
Name:PEREZ-SILVA, MARLENE
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:PEREZ-SILVA
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 1:4738 CONVAIRE AVE
Mailing Address - Street 2:UNITE #3
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-7276
Mailing Address - Country:US
Mailing Address - Phone:702-237-1618
Mailing Address - Fax:
Practice Address - Street 1:4738 CONVAIRE AVE
Practice Address - Street 2:UNITE #3
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-7276
Practice Address - Country:US
Practice Address - Phone:702-237-1618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health