Individual provider · NPI-1

Sierra Elyssa Dejean, OT, OTR/L

Occupational Therapist · Port Saint Lucie, FL

NPI number1629734470
StatusActive
Last updated in NPPESNov 12, 2024

Details

NPI
1629734470
Entity type
Individual (NPI-1)
Name
Sierra Elyssa Dejean
Credential
OT, OTR/L
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 15, 2021
Certification date
Nov 12, 2024
Last updated
Nov 12, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist22498FLYes
225X00000X Occupational TherapistOT22498FL

Practice location

1701 Se Hillmoor Dr
Port Saint Lucie, FL 34952-7552

Phone 772-342-1435

Mailing address

735 18th Ct
Vero Beach, FL 32962-1422

Phone 772-538-0395

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Occupational Therapist providers in Port Saint Lucie, FL