Provider Demographics
NPI:1992537815
Name:PIERSON, ALEXIS BROOKE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:BROOKE
Last Name:PIERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 E GROVE ST APT A
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1860
Mailing Address - Country:US
Mailing Address - Phone:774-269-1945
Mailing Address - Fax:
Practice Address - Street 1:32 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MA
Practice Address - Zip Code:02364-2255
Practice Address - Country:US
Practice Address - Phone:781-582-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist