Healthcare Provider Details

I. General information

NPI: 1881511764
Provider Name (Legal Business Name): KALLIAH SIERRA LEONARD RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 FRANKLIN GTWY SE STE 160
MARIETTA GA
30067-7737
US

IV. Provider business mailing address

1002 WATER OAK TRCE
ACWORTH GA
30102-7514
US

V. Phone/Fax

Practice location:
  • Phone: 678-968-5019
  • Fax:
Mailing address:
  • Phone: 404-955-2254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-539942
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: