Provider Demographics
NPI:1689362667
Name:HALL, SIERRA EVE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:EVE
Last Name:HALL
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5884 WALSH PT APT 206
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2035
Mailing Address - Country:US
Mailing Address - Phone:719-574-5562
Mailing Address - Fax:
Practice Address - Street 1:1130 W WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2726
Practice Address - Country:US
Practice Address - Phone:719-574-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027687225X00000X
COOT.0007821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist