Individual
MR. DERON CHISOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
3604 FERNANDINA RD, 203, COLUMBIA, SC 29210-5221
(803) 750-2211
Mailing address
3604 FERNANDINA RD, 203, COLUMBIA, SC 29210-5221
(803) 750-2211
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5177
SC
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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