Provider Demographics
NPI:1750572418
Name:CHISHOLM, APRIL DAWN (MS)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:DAWN
Last Name:CHISHOLM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 SANDSTONE PASS
Mailing Address - Street 2:APT 1B
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-5040
Mailing Address - Country:US
Mailing Address - Phone:586-381-4855
Mailing Address - Fax:
Practice Address - Street 1:1 FORD PL
Practice Address - Street 2:1E- NEUROPSYCHOLOGY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3450
Practice Address - Country:US
Practice Address - Phone:313-876-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013612390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program