Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | UNLICENSED | |
Y | 102L00000X | Psychologist | PSYPAS00217401 | KY |
Y | 103T00000X | Psychologist | PSYPAS00217401 | KY |
NPI | 1003256884 |
---|---|
Provider Name | Amy Piercy |
First Address | Ashland, KY 41105-0790 |
Second Address | Owingsville, KY 40360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 09/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30610026 | (05) | KY |