Provider Demographics
NPI:1174176044
Name:PIERRE LOUIS, MICH KAREN
Entity type:Individual
Prefix:
First Name:MICH
Middle Name:KAREN
Last Name:PIERRE LOUIS
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 1:75 CALTHEA ST
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1274
Mailing Address - Country:US
Mailing Address - Phone:781-428-1522
Mailing Address - Fax:
Practice Address - Street 1:75 CALTHEA ST
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1274
Practice Address - Country:US
Practice Address - Phone:781-428-1522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE