Provider Demographics
NPI:1699020099
Name:PEIRCE, LINDA A (BCBA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:A
Last Name:PEIRCE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 SW MAPP RD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2446
Mailing Address - Country:US
Mailing Address - Phone:772-888-3431
Mailing Address - Fax:772-221-9969
Practice Address - Street 1:1532 SW MAPP RD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2446
Practice Address - Country:US
Practice Address - Phone:772-486-1789
Practice Address - Fax:772-221-9969
Is Sole Proprietor?:No
Enumeration Date:2012-07-21
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-06-2989103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019108900Medicaid
FL010532400Medicaid