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Individual

MR. IVAN ARTHUR BISHAW JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S. LBSW

Contact information

Practice address
1025 E FOREST AVE, DETROIT, MI 48207-1024
(313) 213-5260
Mailing address
1025 E FOREST AVE, DETROIT, MI 48207-1024
(313) 213-5070

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802068733
MI

Other

Enumeration date
02/26/2016
Last updated
02/26/2016
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