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NPI Code Detail

MEDICARE: MRS. SIERRA SIMONE TROUPE CHILIAN COTA/L

MEDICARE: MRS. SIERRA SIMONE TROUPE CHILIAN COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA002517GA

General Provider Information

NPI Number : 1467911859
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SIERRA SIMONE TROUPE CHILIAN COTA/L
Provider Business Mailing Address
First Line : 134 OVERLOOK PARK LN
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-7356
Country : US
Telephone Number : 314-229-8722
Fax Number :
Provider Business Practice Location Address
First Line : 3750 PEACHTREE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-1385
Country : US
Telephone Number : 404-261-6611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2019
Last Update Date : 03/15/2019

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