Provider Demographics
NPI:1770039117
Name:PEARCE, ANGELICA (TLMFT)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:TLMFT
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:
Other - Last Name:TAMURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1117 GOLDFINCH RD
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:KS
Mailing Address - Zip Code:66439-9537
Mailing Address - Country:US
Mailing Address - Phone:785-486-2154
Mailing Address - Fax:
Practice Address - Street 1:1117 GOLDFINCH RD
Practice Address - Street 2:
Practice Address - City:HORTON
Practice Address - State:KS
Practice Address - Zip Code:66439-9537
Practice Address - Country:US
Practice Address - Phone:785-486-2154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2787106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist