MEDICARE: TIERA NORDAN M.A., BCBA, LBA

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	103K00000X	Behavior Analyst	2025-080	AL

General Provider Information

NPI Number	:	1568087179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIERA NORDAN M.A., BCBA, LBA

Provider Business Mailing Address
First Line	:	17205 REFLECTION ST
Second Line	:
City	:	LOXLEY
State	:	AL
Zip	:	36551-7665
Country	:	US
Telephone Number	:	251-499-0819
Fax Number	:	251-427-0352

Provider Business Practice Location Address
First Line	:	157A N HOYLE AVE
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4827
Country	:	US
Telephone Number	:	251-499-0819
Fax Number	:	251-427-0352

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

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	01/21/2026

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