Provider Demographics
NPI:1033874961
Name:PIERRE, DENISHA (LMT)
Entity Type:Individual
Prefix:
First Name:DENISHA
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 EMBRY LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3719
Mailing Address - Country:US
Mailing Address - Phone:404-908-4749
Mailing Address - Fax:
Practice Address - Street 1:519 JOHNSON FERRY RD STE 350
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4651
Practice Address - Country:US
Practice Address - Phone:404-946-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN083096164W00000X
GAMT013781225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No164W00000XNursing Service ProvidersLicensed Practical Nurse