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NPI Code Detail

MEDICARE: KIERRA MONIQUE GAMBLE

MEDICARE: KIERRA MONIQUE GAMBLE
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-24-394868VA

General Provider Information

NPI Number : 1134937816
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIERRA MONIQUE GAMBLE
Provider Business Mailing Address
First Line : 1164 SEDGWICK DR
Second Line :
City : LOCUST GROVE
State : VA
Zip : 22508-3123
Country : US
Telephone Number : 571-268-3846
Fax Number :
Provider Business Practice Location Address
First Line : 11720 BELTSVILLE DR STE 500
Second Line :
City : BELTSVILLE
State : MD
Zip : 20705-3139
Country : US
Telephone Number : 202-981-8060
Fax Number : 301-889-9735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2024
Last Update Date : 04/21/2026

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Directions to “ KIERRA MONIQUE GAMBLE ” Practice Location

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