Provider Demographics
NPI:1629668504
Name:CUNNINGHAM, SIERRA TAYLER (MA)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:TAYLER
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SHALLOWFORD RD NE APT 8311
Mailing Address - Street 2:2500 SHALLOWFORD RD NE APT 8311
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1243
Mailing Address - Country:US
Mailing Address - Phone:803-747-2262
Mailing Address - Fax:
Practice Address - Street 1:2500 SHALLOWFORD RD NE APT 8311
Practice Address - Street 2:2500 SHALLOWFORD RD NE APT 8311
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-1243
Practice Address - Country:US
Practice Address - Phone:803-747-2262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker