Individual
TRAVIS CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6530 SECOR RD STE 10, LAMBERTVILLE, MI 48144-9456
(734) 854-7061
Mailing address
165 RENFREW AVE, ADRIAN, MI 49221-1807
(417) 588-0977
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006829
MI
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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