Provider Demographics
NPI:1053117838
Name:PERRY, ZARIA
Entity type:Individual
Prefix:
First Name:ZARIA
Middle Name:
Last Name:PERRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 DARBY CREEK RD STE A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1603
Mailing Address - Country:US
Mailing Address - Phone:859-264-8796
Mailing Address - Fax:859-264-9957
Practice Address - Street 1:503 DARBY CREEK RD STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1603
Practice Address - Country:US
Practice Address - Phone:859-264-8796
Practice Address - Fax:859-264-9957
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator