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General NPI Number Information
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NPI Number | 1912333972
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Entity Type | Individual
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Provider Name | SIERRA NICHOLE BEAIRD OT-A
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Gender | Female
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 1400 HIGH SCHOOL DR
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City | MAGNOLIA
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State | AR
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Zip | 71753-2203
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Country | US
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Telephone | 318-381-3681
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Fax |
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Provider Business Mailing Address
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Address Line | 288 GARRIS LN
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City | SPEARSVILLE
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State | LA
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Zip | 71277-2274
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Country | US
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Telephone | 318-381-3681
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | O-T1363
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License Number State | AR
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