| Doctor Name: | KELLY RYAN PEARCE |
| NPI Number: | 1184022055 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCA |
| License Number: | A11279 |
| Business Practice Address: | 502 Peace Haven Rd Kannapolis, NC - 280836957 |
| Business Phone Number: | 9802296818 |
| Business Fax Number: | |
| Mailing Address: | 502 Peace Haven Rd, KANNAPOLIS |
| State: | NC |
| Postal Code: | 280836957 |
| Phone Number: | 9802296818 |
| Fax Number: | |
| NPI Enumeration Date: | 12/09/2014 |
| NPI Last Update Date: | 12/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | A11279 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |