Provider Demographics
NPI:1194576280
Name:PIERCE, CELESTE KATHLEEN (PRSS)
Entity type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:KATHLEEN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:KENOVA
Mailing Address - State:WV
Mailing Address - Zip Code:25530-1027
Mailing Address - Country:US
Mailing Address - Phone:706-817-7481
Mailing Address - Fax:
Practice Address - Street 1:802 OAK ST
Practice Address - Street 2:
Practice Address - City:KENOVA
Practice Address - State:WV
Practice Address - Zip Code:25530-1519
Practice Address - Country:US
Practice Address - Phone:304-908-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV175T00000X
WV1194576280175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist