Individual
ELEANOR KAYE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1333 BREWERY PARK BLVD STE 200, DETROIT, MI 48207-4544
(313) 446-4444
Mailing address
1 LAFAYETTE PLAISANCE ST APT 1617, DETROIT, MI 48207-2865
(404) 593-4494
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
171400000X
Health & Wellness Coach
Primary
—
—
172V00000X
Community Health Worker
—
—
221700000X
Art Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802464510
NON PROFIT
MI
01
—
J525205461773
EXERCISE AND WELLNESS
MI
Enumeration date
01/17/2024
Last updated
01/17/2024
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