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General NPI Number Information
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NPI Number | 1902769110
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Entity Type | Individual
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Provider Name | SIERRA L. HARGRAVE MA
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Gender | Female
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 73 MAIN ST
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City | MONTPELIER
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State | VT
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Zip | 05602-2932
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Country | US
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Telephone | 802-225-8355
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Fax | 802-223-8105
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Provider Business Mailing Address
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Address Line | PO BOX 647
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City | MONTPELIER
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State | VT
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Zip | 05601-0647
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Country | US
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Telephone | 802-225-8355
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Fax | 802-223-8105
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 097.0135855
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License Number State | VT
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