Basic Information
| Provider Information | |||||||||
| NPI: | 1487035226 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIERCE | ||||||||
| FirstName: | RALIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12503 WILLOWBROOK RD | ||||||||
| Address2: | P.O. BOX 1745 | ||||||||
| City: | CUMBERLAND | ||||||||
| State: | MD | ||||||||
| PostalCode: | 215022554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017595280 | ||||||||
| FaxNumber: | 3017775630 | ||||||||
| Practice Location | |||||||||
| Address1: | 12503 WILLOWBROOK RD | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | MD | ||||||||
| PostalCode: | 215022554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017595280 | ||||||||
| FaxNumber: | 3017775630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2015 | ||||||||
| LastUpdateDate: | 01/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | LC7757 | MD | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.