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NPI Code Detail

MEDICARE: SIERRA LEE RBT

MEDICARE: SIERRA LEE RBT
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 TechnicianRBT-17-34971WI

General Provider Information

NPI Number : 1881189868
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA LEE RBT
Provider Business Mailing Address
First Line : 3113 W BELTLINE HWY STE 300
Second Line :
City : MADISON
State : WI
Zip : 53713-2934
Country : US
Telephone Number : 608-819-6810
Fax Number : 608-819-6811
Provider Business Practice Location Address
First Line : 3113 W BELTLINE HWY STE 300
Second Line :
City : MADISON
State : WI
Zip : 53713-2934
Country : US
Telephone Number : 608-819-6810
Fax Number : 608-819-6811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2018
Last Update Date : 06/22/2018

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Directions to “ SIERRA LEE RBT” Practice Location

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