Provider Demographics
NPI:1982371712
Name:ARCHER, SIERRA OLYMPIA (OTR)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:OLYMPIA
Last Name:ARCHER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 ANCHOR WAY STE 6
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4692
Mailing Address - Country:US
Mailing Address - Phone:340-473-5924
Mailing Address - Fax:866-411-7667
Practice Address - Street 1:5030 ANCHOR WAY STE 6
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4692
Practice Address - Country:US
Practice Address - Phone:340-473-5924
Practice Address - Fax:866-411-7667
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
459887OtherNATIONAL BOARD OF OCCUPATIONAL THERAPY