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General NPI Number Information
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NPI Number | 1023257839
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Entity Type | Individual
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Provider Name | JOSEPHINE K PIERCE LISAC
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Gender | Female
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 4425 W OLIVE AVE # 200 & 140
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City | GLENDALE
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State | AZ
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Zip | 85302-3843
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Country | US
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Telephone | 602-685-6000
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Fax | 602-930-0358
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Provider Business Mailing Address
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Address Line | 3003 N CENTRAL AVE SUITE 200
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City | PHOENIX
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State | AZ
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Zip | 85012-2902
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Country | US
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Telephone | 602-302-7715
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Fax | 602-302-7925
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC10215
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License Number State | AZ
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