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NPI Code Detail

MEDICARE: ERICKA GRACE PIERCE

MEDICARE: ERICKA GRACE PIERCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639956170
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICKA GRACE PIERCE
Provider Business Mailing Address
First Line : 5124 23RD AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-3519
Country : US
Telephone Number : 727-336-2783
Fax Number :
Provider Business Practice Location Address
First Line : 10901 ROOSEVELT BLVD N
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33716-2305
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2023
Last Update Date : 09/08/2023

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Directions to “ ERICKA GRACE PIERCE ” Practice Location

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