Individual
MISS AYANA LAKULIA CHISM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
215 HAWKS RD, SUITE 5, MARTIN, TN 38237-2708
(731) 587-3545
(731) 587-3546
Mailing address
536 HUTCHENS RD, APT A, MARTIN, TN 38237-5228
(731) 695-5633
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8638
TN
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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