Provider Demographics
NPI:1447475074
Name:PIERCE-PACHECO, ROBIN N (CDP00678)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:N
Last Name:PIERCE-PACHECO
Suffix:
Gender:F
Credentials:CDP00678
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NORTH UNION STREET
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-725-2520
Mailing Address - Fax:401-723-9595
Practice Address - Street 1:31 NORTH UNION STREET
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:508-676-1307
Practice Address - Fax:508-674-4493
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00678101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)