Individual
MR. JIMMIE LEE JOHNSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR
Contact information
Practice address
20724 EUREKA RD, TAYLOR, MI 48180
(734) 759-0510
(734) 324-3134
Mailing address
20724 EUREKA RD, TAYLOR, MI 48180
(734) 759-0510
(734) 324-3134
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2-00650
MI
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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