Provider Demographics
NPI:1780392605
Name:ATHERTON, SIERRA ROSE HAWKINS (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SIERRA
Middle Name:ROSE HAWKINS
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:SIERRA
Other - Middle Name:ROSE
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 ABRAM CT
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27505-8935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 TROTTERS HILLS CIRCLE
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374
Practice Address - Country:US
Practice Address - Phone:919-774-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15446225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist