Provider Demographics
NPI:1922688100
Name:VIELA, KIERA
Entity Type:Individual
Prefix:
First Name:KIERA
Middle Name:
Last Name:VIELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 WASHBURN WAY STE K
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4531
Mailing Address - Country:US
Mailing Address - Phone:541-885-1675
Mailing Address - Fax:
Practice Address - Street 1:2421 WASHBURN WAY STE K
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4531
Practice Address - Country:US
Practice Address - Phone:541-885-1675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRBT-20-136785106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician