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NPI Code Detail

MEDICARE: AMY PIERCE LMFT

MEDICARE: AMY PIERCE LMFT
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
1106H00000XMarriage & Family Therapist2126MN

General Provider Information

NPI Number : 1477824985
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY PIERCE LMFT
Provider Business Mailing Address
First Line : 475 CLEVELAND AVE N STE 316
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-5051
Country : US
Telephone Number : 651-330-3434
Fax Number : 651-330-3581
Provider Business Practice Location Address
First Line : 475 CLEVELAND AVE N STE 316
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-5051
Country : US
Telephone Number : 651-330-3434
Fax Number : 651-330-3581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2012
Last Update Date : 07/21/2022

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