Provider Demographics
NPI:1588144679
Name:REUTER, SIERRA SAGE (MA)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:SAGE
Last Name:REUTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:SAGE
Other - Last Name:DEROCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-3344
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:820 E 29TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3344
Practice Address - Country:US
Practice Address - Phone:402-494-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist