| Doctor Name: | MRS. MARYBETH PIERROT |
| NPI Number: | 1992077044 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1376654 |
| Business Practice Address: | 14379 Route 9w Circle Of Friends Ravena, NY - 121439602 |
| Business Phone Number: | 5187563124 |
| Business Fax Number: | 5187569476 |
| Mailing Address: | 14379 Route 9w, Circle Of Friends RAVENA |
| State: | NY |
| Postal Code: | 12143 |
| Phone Number: | 5187563124 |
| Fax Number: | 5187569476 |
| NPI Enumeration Date: | 02/06/2012 |
| NPI Last Update Date: | 02/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 1376654 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |