Individual
DR. KEVIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
363 W BIG BEAVER RD STE 400, TROY, MI 48084-5242
(248) 509-7657
Mailing address
363 W BIG BEAVER RD STE 400, TROY, MI 48084-5242
(810) 300-3178
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301019443
MI
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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