Provider Demographics
NPI:1093007957
Name:PEARCE, CORY (PHD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:
Last Name:PEARCE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 CORONADO CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3977
Mailing Address - Country:US
Mailing Address - Phone:702-660-9062
Mailing Address - Fax:844-697-8698
Practice Address - Street 1:871 CORONADO CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3977
Practice Address - Country:US
Practice Address - Phone:702-660-9062
Practice Address - Fax:844-697-8698
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0675103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical