Healthcare Provider Details

I. General information

NPI: 1861324618
Provider Name (Legal Business Name): MARA PIERCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 BANKTON CIR
HANAHAN SC
29410-2957
US

IV. Provider business mailing address

1000 BONIETA HARROLD DR APT 7206
CHARLESTON SC
29414-5172
US

V. Phone/Fax

Practice location:
  • Phone: 843-939-3223
  • Fax:
Mailing address:
  • Phone: 843-939-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7966
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: