Provider Demographics
NPI:1629266945
Name:SIERRA, GABRIELA I (MA)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:I
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 1:828 HANNAH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-2006
Mailing Address - Country:US
Mailing Address - Phone:708-257-6074
Mailing Address - Fax:
Practice Address - Street 1:828 HANNAH AVE
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-2006
Practice Address - Country:US
Practice Address - Phone:708-257-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities