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NPI Code Detail

MEDICARE: JENNIFER CIERRA IKOLA BCBA

MEDICARE: JENNIFER CIERRA IKOLA 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 Analyst1-17-25229CA

General Provider Information

NPI Number : 1811420623
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CIERRA IKOLA BCBA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 951-809-5784
Fax Number :
Provider Business Practice Location Address
First Line : 424 CHURCH ST STE 2000
Second Line :
City : NASHVILLE
State : TN
Zip : 37219-3304
Country : US
Telephone Number : 951-809-5784
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2017
Last Update Date : 05/19/2022

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