Basic Information
| Provider Information | |||||||||
| NPI: | 1982194478 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIERCE | ||||||||
| FirstName: | DEVIN | ||||||||
| MiddleName: | RAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D., LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27 RANDOLPH RD | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077318611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667081240 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5217 VILLAGE CREEK DR | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750934416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727350306 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2018 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | 38196 | TX | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103TC0700X | 38196 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.