Provider Demographics
NPI:1558448514
Name:HENAO, LEONOR VERA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:LEONOR
Middle Name:VERA
Last Name:HENAO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 BEDDINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545
Mailing Address - Country:US
Mailing Address - Phone:919-217-0949
Mailing Address - Fax:
Practice Address - Street 1:820 S BOYLON AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2176
Practice Address - Country:US
Practice Address - Phone:919-733-5576
Practice Address - Fax:919-733-7365
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist