Provider Demographics
NPI:1053157222
Name:SIERRA, EMELIZIA SILVA (BA)
Entity type:Individual
Prefix:
First Name:EMELIZIA
Middle Name:SILVA
Last Name:SIERRA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7018 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1215
Mailing Address - Country:US
Mailing Address - Phone:401-871-3342
Mailing Address - Fax:
Practice Address - Street 1:500 W ARCHER ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1811
Practice Address - Country:US
Practice Address - Phone:401-871-3342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty