Provider Demographics
NPI:1821545393
Name:PIERCE, SHARNIECE (DOT)
Entity Type:Individual
Prefix:
First Name:SHARNIECE
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:DOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20830 N TATUM BLVD STE 170
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7252
Mailing Address - Country:US
Mailing Address - Phone:480-502-5510
Mailing Address - Fax:480-538-4862
Practice Address - Street 1:9097 E DESERT COVE AVE STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6276
Practice Address - Country:US
Practice Address - Phone:480-565-1897
Practice Address - Fax:480-860-0356
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist