Provider Demographics
NPI:1245045889
Name:MOULTRIE, KIERRA JAHNAE (MSW)
Entity type:Individual
Prefix:
First Name:KIERRA
Middle Name:JAHNAE
Last Name:MOULTRIE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 SPRING ST NW APT 16G
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3187
Mailing Address - Country:US
Mailing Address - Phone:404-323-5381
Mailing Address - Fax:
Practice Address - Street 1:2551 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4762
Practice Address - Country:US
Practice Address - Phone:312-678-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker