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NPI Code Detail

MEDICARE: SIERRA MARIE BROWN

MEDICARE: SIERRA MARIE BROWN
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 Analyst

General Provider Information

NPI Number : 1497254973
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA MARIE BROWN
Provider Business Mailing Address
First Line : 15 N 12TH ST
Second Line :
City : BELLEVILLE
State : IL
Zip : 62220-1001
Country : US
Telephone Number : 636-524-9009
Fax Number :
Provider Business Practice Location Address
First Line : 11939 MANCHESTER RD # 162
Second Line :
City : DES PERES
State : MO
Zip : 63131-4502
Country : US
Telephone Number : 314-626-0306
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2018
Last Update Date : 02/09/2018

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Directions to “ SIERRA MARIE BROWN ” Practice Location

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