MEDICARE: SIERRA RIOS

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
1	101YP2500X	Professional Counselor	PC015936	PA

General Provider Information

NPI Number	:	1710708789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA RIOS

Provider Business Mailing Address
First Line	:	6328 STERLING AVE
Second Line	:
City	:	BENSALEM
State	:	PA
Zip	:	19020-2544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6328 STERLING AVE
Second Line	:
City	:	BENSALEM
State	:	PA
Zip	:	19020-2544
Country	:	US
Telephone Number	:	267-265-4850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2024
Last Update Date	:	10/22/2024

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Directions to “ SIERRA RIOS ” Practice Location

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