MEDICARE: MISS CIERA PRYOR

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1548096597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CIERA PRYOR

Provider Business Mailing Address
First Line	:	111 MACKENAN DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-7903
Country	:	US
Telephone Number	:	919-371-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 E 70TH ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4830
Country	:	US
Telephone Number	:	919-371-2848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	09/09/2024

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Directions to “ MISS CIERA PRYOR ” Practice Location

Language	Start Address	Practice Location

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