Provider Demographics
NPI:1912291618
Name:LOVE, EMILY ANNA PEARCE (PSYD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNA PEARCE
Last Name:LOVE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANNA
Other - Last Name:PEARCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:235 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373-9753
Mailing Address - Country:US
Mailing Address - Phone:413-475-0086
Mailing Address - Fax:909-752-4363
Practice Address - Street 1:235 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTH DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01373
Practice Address - Country:US
Practice Address - Phone:413-475-0086
Practice Address - Fax:909-752-4363
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10869103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical