Provider Demographics
NPI:1528182912
Name:CIERRA THERAPY LLC
Entity Type:Organization
Organization Name:CIERRA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERRI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:208-734-6700
Mailing Address - Street 1:PO BOX 5544
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-5544
Mailing Address - Country:US
Mailing Address - Phone:208-734-6700
Mailing Address - Fax:208-734-6795
Practice Address - Street 1:1201 FALLS AVE E
Practice Address - Street 2:SUITE 36
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301
Practice Address - Country:US
Practice Address - Phone:208-734-6700
Practice Address - Fax:208-734-6795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDSPA77OtherBLUE CROSS