Provider Demographics
NPI:1003461013
Name:PIERCE, REBECCA (PSYD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CENTURY PKWY
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8043
Mailing Address - Country:US
Mailing Address - Phone:312-448-4821
Mailing Address - Fax:
Practice Address - Street 1:935 W RALPH HALL PKWY STE 105
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-8707
Practice Address - Country:US
Practice Address - Phone:972-772-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2023-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39008103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist