=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841536760
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY ERIN TIERCE P.T. , D.P.T
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2012
-----------------------------------------------------
Last Update Date | 12/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 765 ORANGE ST
-----------------------------------------------------
City | ABILENE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79601-5011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-690-5103
-----------------------------------------------------
Fax | 325-690-5228
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2616 S CLACK ST
-----------------------------------------------------
City | ABILENE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79606-1557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-690-5103
-----------------------------------------------------
Fax | 325-690-5228
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 1179503
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------