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General NPI Number Information
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NPI Number | 1235283334
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Entity Type | Individual
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Provider Name | JESSICA MARJORIE PEIRCE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5200 EASTERN AVE MASON F. LORD, 6TH FLOOR EAST
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City | BALTIMORE
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State | MD
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Zip | 21224-2734
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Country | US
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Telephone | 410-550-5828
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Fax | 410-550-0060
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Provider Business Mailing Address
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Address Line | 6532 SEAPEARL LN
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City | COLUMBIA
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State | MD
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Zip | 21045-4652
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Country | US
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Telephone | 410-550-5828
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Fax | 410-550-0060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 03939
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License Number State | MD
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