Healthcare Provider Details

I. General information

NPI: 1477141844
Provider Name (Legal Business Name): MARSHA A PIERRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2021
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 S UNIVERSITY DR
DAVIE FL
33328-5312
US

IV. Provider business mailing address

5273 SW 40TH AVE
FORT LAUDERDALE FL
33314-6501
US

V. Phone/Fax

Practice location:
  • Phone: 954-998-4304
  • Fax:
Mailing address:
  • Phone: 718-576-9197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20266
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: