Provider Demographics
NPI:1396400370
Name:PEARSE, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:PEARSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ALLSTON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2487
Mailing Address - Country:US
Mailing Address - Phone:978-973-5775
Mailing Address - Fax:
Practice Address - Street 1:30 ALLSTON ST APT 3
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2487
Practice Address - Country:US
Practice Address - Phone:978-973-5775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician