Individual
SHAUNTEZ ANIONIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 424-3513
Mailing address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 424-3513
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6851108961
MI
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/07/2020
Last updated
09/18/2023
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