Provider Demographics
NPI:1548512981
Name:KIERAS, LEANNE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:KIERAS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 OLEANDER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4787
Mailing Address - Country:US
Mailing Address - Phone:910-313-2111
Mailing Address - Fax:910-313-2119
Practice Address - Street 1:5911 OLEANDER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4787
Practice Address - Country:US
Practice Address - Phone:910-313-2111
Practice Address - Fax:910-313-2119
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8478225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics