Provider Demographics
NPI:1871925149
Name:VARGAS, CIERRA MARIE
Entity type:Individual
Prefix:MISS
First Name:CIERRA
Middle Name:MARIE
Last Name:VARGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 N 1375 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3049
Mailing Address - Country:US
Mailing Address - Phone:801-375-2523
Mailing Address - Fax:
Practice Address - Street 1:836 N 1375 W
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3049
Practice Address - Country:US
Practice Address - Phone:801-375-2523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor