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General NPI Number Information
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NPI Number | 1245321298
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Entity Type | Organization
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Legal Business Name | RONALD D. PEARSE,EDD
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1314 LOCUST AVE.
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City | FAIRMONT
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State | WV
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Zip | 26554
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Country | US
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Telephone | 304-367-0232
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Fax | 304-367-0233
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Provider Business Mailing Address
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Address Line | 1314 LOCUST AVE.
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City | FAIRMONT
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State | WV
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Zip | 26554
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Country | US
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Telephone | 304-367-0232
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Fax | 304-367-0233
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. RONALD D. PEARSE
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Credential | ED.D
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Telephone | 304-367-9232
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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 | 20
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License Number State | WV
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