Demetrias Chisolm
Counselor, Professional in N Charleston, SC. Individual provider (NPI-1).
NPI number1053404251
StatusActive
Last updated in NPPESFeb 24, 2021
Details
- NPI
- 1053404251
- Entity type
- Individual (NPI-1)
- Name
- Demetrias Chisolm
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 2, 2006
- Certification date
- Feb 24, 2021
- Last updated
- Feb 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 7692 | SC | Yes |
Practice location
3945 Rivers AveN Charleston, SC 29405-7042
Phone 843-345-5037
Mailing address
9867 Black Tupelo LnLadson, SC 29456-8536
Phone 843-345-5037
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