Individual
LIESEL S CHIVINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1200 N WEST AVE, SUITE 400, JACKSON, MI 49202-2179
(517) 780-3336
(517) 796-4561
Mailing address
7066 HUBERT RD, APT 1, HUBBARD LAKE, MI 49747-9752
(989) 727-3834
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401008011
MI
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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