Individual
SIERRA SAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
24 MACARTHUR BLVD, SOMERS POINT, NJ 08244-1776
(609) 927-1991
Mailing address
24 MACARTHUR BLVD, SOMERS POINT, NJ 08244-1776
(609) 927-1991
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01055800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTHER
—
NJ
Enumeration date
05/02/2022
Last updated
06/02/2022
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