Provider Demographics
NPI:1215622618
Name:FREID, SIERRA NICHOLE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:SIERRA
Middle Name:NICHOLE
Last Name:FREID
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 VANCE ST APT 328
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-7014
Mailing Address - Country:US
Mailing Address - Phone:715-418-1429
Mailing Address - Fax:
Practice Address - Street 1:2355 CANYON BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5652
Practice Address - Country:US
Practice Address - Phone:303-974-9710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.007230225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics