Provider Demographics
NPI:1063588697
Name:PIERCE, PAUL ARTHUR BRYON (EDD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ARTHUR BRYON
Last Name:PIERCE
Suffix:
Gender:
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 KING PHILIP AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373-1126
Mailing Address - Country:US
Mailing Address - Phone:413-397-3116
Mailing Address - Fax:
Practice Address - Street 1:39 KING PHILIP AVE
Practice Address - Street 2:
Practice Address - City:SOUTH DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01373-1126
Practice Address - Country:US
Practice Address - Phone:413-397-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0077103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W01923Medicare ID - Type Unspecified