Provider Demographics
NPI:1376252072
Name:UBIERA, SIDNEY
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:
Last Name:UBIERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 ORTON MAROTTA WAY APT 2046
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2000
Mailing Address - Country:US
Mailing Address - Phone:267-266-0024
Mailing Address - Fax:
Practice Address - Street 1:13 FLAHERTY WAY
Practice Address - Street 2:APT 2046
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127
Practice Address - Country:US
Practice Address - Phone:267-266-0024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician