Individual
ENRIQUE SIERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
199 PARK ST, BRIDGEPORT, CT 06608-1637
(407) 314-7058
Mailing address
199 PARK ST, BRIDGEPORT, CT 06608-1637
(407) 314-7058
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
03237158
CT
224Z00000X
Occupational Therapy Assistant
46TA09096000
NJ
224Z00000X
Occupational Therapy Assistant
Primary
OTA11654
FL
Other
Enumeration date
06/27/2015
Last updated
06/27/2015
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