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NPI Code Detail

MEDICARE: MRS. SIERRA MADISON BCBA

MEDICARE: MRS. SIERRA MADISON BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2018-068AL

General Provider Information

NPI Number : 1457859191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SIERRA MADISON BCBA
Provider Business Mailing Address
First Line : 306 WYNN DR NW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35805-1961
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 306 WYNN DR NW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35805-1961
Country : US
Telephone Number : 256-882-2457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2018
Last Update Date : 02/08/2019

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Directions to “ MRS. SIERRA MADISON BCBA” Practice Location

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