Individual
MR. TYRONE CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS/MHC, LLPC
Contact information
Practice address
114 ORCHARD LAKE RD, PONTIAC, MI 48341-2244
(248) 858-7766
Mailing address
4173 11TH ST, ECORSE, MI 48229-1220
(313) 254-7034
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401012248
MI
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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