Provider Demographics
NPI:1508208166
Name:LEVINER, CIERRA HARRIS (MS)
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:HARRIS
Last Name:LEVINER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3442
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-3442
Mailing Address - Country:US
Mailing Address - Phone:910-521-1677
Mailing Address - Fax:910-521-1676
Practice Address - Street 1:812 CANDY PARK RD
Practice Address - Street 2:SUITE 7101A
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9129
Practice Address - Country:US
Practice Address - Phone:910-521-1677
Practice Address - Fax:910-521-1676
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10422235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist