Provider Demographics
NPI:1750514089
Name:PIERCE, KATHERINE ELIZABETH (PSYD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BUREAU OF MEDICINE & SURGERY DETACHMENT JACKSONVILLE
Mailing Address - Street 2:NAS JACKSONVILLE BUILDING 554
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32212-0140
Mailing Address - Country:US
Mailing Address - Phone:877-772-4373
Mailing Address - Fax:
Practice Address - Street 1:BUREAU OF MEDICINE & SURGERY DETACHMENT JACKSONVILLE
Practice Address - Street 2:NAS JACKSONVILLE BUILDING 554
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:877-772-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4237103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical