Individual
MELISSA S CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TSW
Contact information
Practice address
2410 GRAPE RD STE 6, MISHAWAKA, IN 46545-3015
(574) 217-0128
(574) 288-3447
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012266A
IN
171M00000X
Case Manager/Care Coordinator
99113060A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33012266A
CSW
IN
Enumeration date
12/05/2019
Last updated
05/23/2024
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