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Individual

DANA CHISHOLM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16321 LORAIN AVE APT 112, CLEVELAND, OH 44111-5525
(216) 618-8545
Mailing address
16321 LORAIN AVE APT 112, CLEVELAND, OH 44111-5525
(216) 618-8545

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
OH
175T00000X
Peer Specialist
Primary
001043
OH

Other

Enumeration date
08/23/2019
Last updated
02/03/2021
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