Individual
MS. BEVERLY J. CHISHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
575 S MAIN ST, SUITE 6, PLYMOUTH, MI 48170-1778
(734) 451-7800
Mailing address
2975 TAYLOR ST, DETROIT, MI 48206-1910
(734) 451-7800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6801063157
MI
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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