Individual
SIERRA L PARHAM-GANTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13136 WESTERN AVE, BLUE ISLAND, IL 60406-2423
(708) 974-5800
Mailing address
13136 WESTERN AVE, BLUE ISLAND, IL 60406-2423
(708) 974-5800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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