Perry, Statisha L
Perry, Statisha L is an individual health care provider with primary practice located at 2300 W Park Place Blvd Ste 135 Suite 135, Stone Mountain GA 30087-3561. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Perry, Statisha L can be contacted via phone (678) 330-1400.Contact Information
Primary practice address
2300 W Park Place Blvd Ste 135 Suite 135
Stone Mountain GA 30087-3561
Phone: (678) 330-1400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1275003337 |
|---|---|
| LBN Legal business name | Perry, Statisha L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 3rd, 2018 |
| Last updated | Dec 3rd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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