Individual
JALEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5312
(248) 436-4400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
08/12/2025
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