Individual
CYD CHARISSE GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LLPC,LBSW
Contact information
Practice address
45660 SCHOENHERR RD STE A, SHELBY TOWNSHIP, MI 48315-6033
(586) 566-3020
(586) 566-3055
Mailing address
45660 SCHOENHERR RD STE A, UTICA, MI 48315-6033
(586) 566-3020
(586) 566-3055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401014502
MI
Other
Enumeration date
06/13/2015
Last updated
05/02/2019
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