MEDICARE: KETHIA DORCEUS PIERRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	P019424	NC

General Provider Information

NPI Number	:	1245896083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KETHIA DORCEUS PIERRE

Provider Business Mailing Address
First Line	:	5518 ARNOLD PALMER DR APT 1226
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-1931
Country	:	US
Telephone Number	:	407-300-2846
Fax Number	:

Provider Business Practice Location Address
First Line	:	3077 N MAIN ST STE 201
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-1735
Country	:	US
Telephone Number	:	910-275-5766
Fax Number	:	866-990-0668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	09/09/2024

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Directions to “ KETHIA DORCEUS PIERRE ” Practice Location

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