Provider Demographics
NPI:1164139044
Name:SIERRA, GABRIELA P (MA)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:P
Last Name:SIERRA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 SCHUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-2912
Mailing Address - Country:US
Mailing Address - Phone:201-496-3887
Mailing Address - Fax:
Practice Address - Street 1:1036 AMBOY AVE
Practice Address - Street 2:2ND STREET ENTRANCE
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-0883
Practice Address - Country:US
Practice Address - Phone:732-587-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty