Individual
SIERA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2004 EASTVIEW PKWY STE 105, CONYERS, GA 30013-5705
(678) 905-1500
(678) 374-3908
Mailing address
95 PARTRIDGE DR STE 105, COVINGTON, GA 30016-1185
(678) 905-1500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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