Basic Information
| Provider Information | |||||||||
| NPI: | 1942667720 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERRY | ||||||||
| FirstName: | DREW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53 SALEM AVE UNIT A | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288043337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145738121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11698 HURON ST UNIT 106 | ||||||||
| Address2: | |||||||||
| City: | NORTHGLENN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802342950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203810264 | ||||||||
| FaxNumber: | 3039844366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2016 | ||||||||
| LastUpdateDate: | 06/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.