Provider Demographics
NPI:1235916164
Name:SIERRA, CRISTINA MARLENE (MS SLP-CF)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARLENE
Last Name:SIERRA
Suffix:
Gender:F
Credentials:MS SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2817
Mailing Address - Country:US
Mailing Address - Phone:786-863-4632
Mailing Address - Fax:
Practice Address - Street 1:8900 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2817
Practice Address - Country:US
Practice Address - Phone:786-863-4632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist