MEDICARE: MERLYNE PIERRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	S78175876	MA

General Provider Information

NPI Number	:	1831500982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERLYNE PIERRE

Provider Business Mailing Address
First Line	:	712 W MAIN ST
Second Line	:
City	:	AVON
State	:	MA
Zip	:	02322-1744
Country	:	US
Telephone Number	:	617-372-7297
Fax Number	:

Provider Business Practice Location Address
First Line	:	3313 WASHINGTON ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-2691
Country	:	US
Telephone Number	:	617-522-0650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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Directions to “ MERLYNE PIERRE ” Practice Location

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