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General NPI Number Information
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NPI Number | 1962263368
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Entity Type | Individual
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Provider Name | SIERRA GRAHAM-COOPER MSW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 7155 KERR PL
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-1640
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Country | US
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Telephone | 901-497-6827
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 S RED BANKS RD
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City | HOLLY SPRINGS
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State | MS
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Zip | 38635-8436
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Country | US
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Telephone | 901-292-8244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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