Provider Demographics
NPI:1912333972
Name:BEAIRD, SIERRA NICHOLE (OT-A)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:NICHOLE
Last Name:BEAIRD
Suffix:
Gender:F
Credentials:OT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 GARRIS LN
Mailing Address - Street 2:
Mailing Address - City:SPEARSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71277-2274
Mailing Address - Country:US
Mailing Address - Phone:318-381-3681
Mailing Address - Fax:
Practice Address - Street 1:1400 HIGH SCHOOL DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2203
Practice Address - Country:US
Practice Address - Phone:318-381-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARO-T1363224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant