Individual
MICHELLE E SIERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
653 MYRTLE DRIVE, COVINGTON, LA 70433
(985) 893-4700
(985) 893-3211
Mailing address
653 MYRTLE DRIVE, COVINGTON, LA 70433
(985) 893-4700
(985) 893-3211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
02679
LA
2251X0800X
Orthopedic Physical Therapist
Primary
02679
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5211614
AETNA PROVIDER NUMBER
LA
01
—
535-67-3751A
BLUE CROSS BLUE SHIELD
LA
Enumeration date
06/14/2005
Last updated
06/15/2018
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