Provider Demographics
NPI:1861916405
Name:PERALES, KATY ANNE
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:ANNE
Last Name:PERALES
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 1:83 PEARL STREET
Mailing Address - Street 2:CAPE COD CHILD DEVELOPMENT
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-775-6240
Mailing Address - Fax:508-437-0335
Practice Address - Street 1:83 PEARL STREET
Practice Address - Street 2:CAPE COD CHILD DEVELOPMENT
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-775-6240
Practice Address - Fax:508-437-0335
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist