Individual
SIERRA FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1218 EAST BLVD, CHESTERFIELD, SC 29709-5148
(843) 623-7062
Mailing address
717 BROOKE RD, CHERAW, SC 29520-6367
(843) 288-9093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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