Perry Revels

NPI 1518313394 · on the registry since 2016

Practice

Address: 1705 Felicia Ave
Tallulah, LA 71282
Phone: (318) 574-1232
Organisation at this address: Cognitive Development
Cognitive Development Center
Cognitive Development Center, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 92

Registry record

Primary taxonomy: 101Y00000X
101Y00000X
Also registered as: 101YM0800X
171M00000X
Licence states on file: LA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-03-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana