Provider Demographics
NPI:1124854971
Name:SIERRA, GABRIELLE (SLP)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 BRONXVILLE RD APT 1J
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10708-1137
Mailing Address - Country:US
Mailing Address - Phone:646-285-5116
Mailing Address - Fax:
Practice Address - Street 1:120 W 231ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5905
Practice Address - Country:US
Practice Address - Phone:718-601-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034564235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist