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NPI Code Detail

MEDICARE: JENNA SIERRA BROWN-GORE

MEDICARE: JENNA SIERRA BROWN-GORE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1538889662
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA SIERRA BROWN-GORE
Provider Business Mailing Address
First Line : 5639 IVY KNOLL CT APT C
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3717
Country : US
Telephone Number : 757-613-0490
Fax Number :
Provider Business Practice Location Address
First Line : 15570 STONY CREEK WAY
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-4385
Country : US
Telephone Number : 317-732-5717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2022
Last Update Date : 06/24/2025

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Directions to “ JENNA SIERRA BROWN-GORE ” Practice Location

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