Healthcare Provider Details

I. General information

NPI: 1235806357
Provider Name (Legal Business Name): SIEERA BROOKE LAMBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 BUSH ST
RALEIGH NC
27609-7511
US

IV. Provider business mailing address

PO BOX 749
BELMONT NC
28012-0749
US

V. Phone/Fax

Practice location:
  • Phone: 984-204-1233
  • Fax: 984-459-9295
Mailing address:
  • Phone: 704-869-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3492
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: