Individual
MRS. CHRISTINA MARIE MITCHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 456-1443
(616) 732-6392
Mailing address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 456-1443
(616) 732-6392
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801088032
MI
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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