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Individual
SIERRA PEMBROKE
Active
Individual
SIERRA PEMBROKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0137112
VT
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
097.0134963
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6721318
—
VT
05
—
6722978
—
VT
Enumeration date
07/23/2025
Last updated
03/16/2026
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