Provider Demographics
NPI:1235712936
Name:PIERCE, JASON N (TYPE 1)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:N
Last Name:PIERCE
Suffix:
Gender:M
Credentials:TYPE 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-5703
Mailing Address - Country:US
Mailing Address - Phone:978-204-3008
Mailing Address - Fax:
Practice Address - Street 1:27 FERN AVE
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-5703
Practice Address - Country:US
Practice Address - Phone:978-204-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13897225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty