Individual
CHEYENNE AUTUMN HISSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 25TH STREET, MOREHEAD, KY 40351
(866) 233-1955
Mailing address
1939 S DIVISION AVE, GRAND RAPIDS, MI 49507
(616) 247-3815
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801104291
MI
Other
Enumeration date
06/05/2019
Last updated
02/28/2025
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