Provider Demographics
NPI:1205979010
Name:PEIRCE, JOELLA AUDIA
Entity type:Individual
Prefix:MS
First Name:JOELLA
Middle Name:AUDIA
Last Name:PEIRCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 BRISTOL HWY
Mailing Address - Street 2:202
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1400
Mailing Address - Country:US
Mailing Address - Phone:423-283-6500
Mailing Address - Fax:423-283-6550
Practice Address - Street 1:3915 BRISTOL HWY
Practice Address - Street 2:202
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1400
Practice Address - Country:US
Practice Address - Phone:423-283-6500
Practice Address - Fax:423-283-6550
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor