Most Relevant Information
Provider Data
| NPI Number: | 1003515057 |
| Provider Name: | MIRNA SUGEY RETANA PEREZ |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/28/2023 |
| Last Updated: | 09/30/2024 |
Provider Practice Location
702 SUNSET DR
ONTARIO
OR
979143121
Practice Location Phone/Fax
| Phone: | 5418899167 |
| Fax: | 5418897873 |
Provider Mailing Location
702 SUNSET DR
ONTARIO
OR
979143121
Provider Mailing Phone/Fax
| Phone: | 5418899167 |
| Fax: | 5418897873 |