Provider Demographics
NPI:1821736968
Name:PIERCE ABA
Entity Type:Organization
Organization Name:PIERCE ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-200-1100
Mailing Address - Street 1:11 HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-2514
Mailing Address - Country:US
Mailing Address - Phone:860-200-1100
Mailing Address - Fax:
Practice Address - Street 1:11 HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-2514
Practice Address - Country:US
Practice Address - Phone:860-200-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty