Provider Demographics
NPI:1477295921
Name:REED, SIERRA NICOLE HARISAY (ATS)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:NICOLE HARISAY
Last Name:REED
Suffix:
Gender:F
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 FLICKER DR APT 184
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-7167
Mailing Address - Country:US
Mailing Address - Phone:650-722-8943
Mailing Address - Fax:
Practice Address - Street 1:2240 FLICKER DR APT 184
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-7167
Practice Address - Country:US
Practice Address - Phone:650-722-8943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer