Individual
DEMETRIAS CHISOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3945 RIVERS AVE, N CHARLESTON, SC 29405-7042
(843) 345-5037
Mailing address
9867 BLACK TUPELO LN, LADSON, SC 29456-8536
(843) 345-5037
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7692
SC
Other
Enumeration date
10/02/2006
Last updated
02/24/2021
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