Individual
LESLIE SHANNON RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
808 BACON ST, DURHAM, NC 27703-5006
(919) 560-2000
Mailing address
25 HAWTHORNE DR, DURHAM, NC 27712-3225
(919) 619-0304
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12090
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12090
—
NC
Enumeration date
02/19/2019
Last updated
04/13/2026
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