| NPI | 1831524651 |
|---|---|
| Former Name | TRISTA ALESE PEREZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA 004691) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2013006408) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS 2193) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2013006408) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2023-04-11 |