Provider Demographics
NPI:1790567733
Name:GREEN-MCDOWELL, SIERRA MARISSA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:MARISSA
Last Name:GREEN-MCDOWELL
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 SPRING STUEBNER RD STE 600
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-4812
Mailing Address - Country:US
Mailing Address - Phone:817-562-0909
Mailing Address - Fax:
Practice Address - Street 1:2045 SPRING STUEBNER RD STE 600
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-4812
Practice Address - Country:US
Practice Address - Phone:817-562-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst