Provider Demographics
NPI:1265115422
Name:DOWELL, KIERA
Entity type:Individual
Prefix:
First Name:KIERA
Middle Name:
Last Name:DOWELL
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 1:350 WESTLAKE DR N
Mailing Address - Street 2:
Mailing Address - City:LAKE LURE
Mailing Address - State:NC
Mailing Address - Zip Code:28746-9652
Mailing Address - Country:US
Mailing Address - Phone:704-650-5247
Mailing Address - Fax:
Practice Address - Street 1:350 WESTLAKE DR N
Practice Address - Street 2:
Practice Address - City:LAKE LURE
Practice Address - State:NC
Practice Address - Zip Code:28746-9652
Practice Address - Country:US
Practice Address - Phone:704-650-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06975700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker