Provider Demographics
NPI:1710564588
Name:MEYER, SIERRA (RBT)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:356C BROAD STREET, 3RD FLOOR
Mailing Address - Street 2:ATTN REBECCA KHALIL
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-3042
Mailing Address - Country:US
Mailing Address - Phone:978-732-3982
Mailing Address - Fax:888-589-1524
Practice Address - Street 1:501 GRANARY RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-3042
Practice Address - Country:US
Practice Address - Phone:410-836-7700
Practice Address - Fax:888-589-1524
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDRBT-21-156156106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician