Provider Demographics
NPI:1376825125
Name:PIERGIOVANNI, DANA RENEE (MA, LPC, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:RENEE
Last Name:PIERGIOVANNI
Suffix:
Gender:F
Credentials:MA, LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 W PROFESSIONAL PARK CT STE 1
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3250
Mailing Address - Country:US
Mailing Address - Phone:270-777-9283
Mailing Address - Fax:
Practice Address - Street 1:1001 W 9TH AVE STE BANDC
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1209
Practice Address - Country:US
Practice Address - Phone:610-831-1865
Practice Address - Fax:877-891-3208
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-10-7684103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst