Provider Demographics
NPI:1669645198
Name:SYDNOR, QUIANA SHE'REE (LPC)
Entity Type:Individual
Prefix:MS
First Name:QUIANA
Middle Name:SHE'REE
Last Name:SYDNOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 BOGGS RD
Mailing Address - Street 2:#2322
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1201
Mailing Address - Country:US
Mailing Address - Phone:770-784-0076
Mailing Address - Fax:
Practice Address - Street 1:175 GWINNETT DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8444
Practice Address - Country:US
Practice Address - Phone:770-339-5377
Practice Address - Fax:770-339-5016
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional