Provider Demographics
NPI:1023605896
Name:DULANEY, KIARA GRACE (OTR/L)
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:GRACE
Last Name:DULANEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 HARMONY HILL LN APT 2316
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-0156
Mailing Address - Country:US
Mailing Address - Phone:601-750-9094
Mailing Address - Fax:
Practice Address - Street 1:10010 HARMONY HILL LN APT 2316
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-0156
Practice Address - Country:US
Practice Address - Phone:601-750-9094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist