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General NPI Number Information
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NPI Number | 1548701485
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Entity Type | Organization
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Legal Business Name | MARSHA PIERSON, LCSW
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Dates
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Enumeration Date | 03/11/2017
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Last Update Date | 03/11/2017
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Provider Practice Location Address
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Address Line | 222 WELLER ST
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City | PETALUMA
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State | CA
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Zip | 94952-3183
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Country | US
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Telephone | 202-302-0617
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Fax |
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Provider Business Mailing Address
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Address Line | 101 2ND ST APT 310
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City | PETALUMA
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State | CA
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Zip | 94952-7405
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Country | US
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Telephone | 202-302-0617
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MARSHA P PIERSON
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Credential | LCSW
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Telephone | 707-776-6169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 70835
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License Number State | CA
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