Provider Demographics
NPI:1407481377
Name:STORER, CIARA ROSE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:ROSE
Last Name:STORER
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 1:11183 CLAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2364
Mailing Address - Country:US
Mailing Address - Phone:919-243-2201
Mailing Address - Fax:
Practice Address - Street 1:11183 CLAYTON BLVD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2364
Practice Address - Country:US
Practice Address - Phone:919-243-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13276225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist