Provider Demographics
NPI:1962263368
Name:GRAHAM-COOPER, SIERRA (MSW)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:GRAHAM-COOPER
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 1:1424 S RED BANKS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-8436
Mailing Address - Country:US
Mailing Address - Phone:901-292-8244
Mailing Address - Fax:
Practice Address - Street 1:7155 KERR PL
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-1640
Practice Address - Country:US
Practice Address - Phone:901-497-6827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker