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General NPI Number Information
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NPI Number | 1124244280
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Entity Type | Individual
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Provider Name | JOE BOB PIERCE JR. L.M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 527 ALLEN ST
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City | OWENSBORO
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State | KY
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Zip | 42303-3437
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Country | US
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Telephone | 270-685-0110
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Fax | 270-683-4105
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Provider Business Mailing Address
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Address Line | 2308 REIGH COUNT DR
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City | OWENSBORO
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State | KY
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Zip | 42301-4985
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Country | US
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Telephone | 270-685-0110
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Fax | 270-683-4105
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 0035
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0427
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License Number State | KY
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