Provider Demographics
NPI:1073160511
Name:PEARCE, AYANNA (DPT)
Entity Type:Individual
Prefix:
First Name:AYANNA
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 BRICKYARD BLVD APT 3031
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1640
Mailing Address - Country:US
Mailing Address - Phone:203-400-9372
Mailing Address - Fax:
Practice Address - Street 1:8380 COLESVILLE RD UNIT 270
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6255
Practice Address - Country:US
Practice Address - Phone:301-563-3081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12391225100000X
MD28397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist