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Individual

MISS MARIA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
148 CANFIELD DR, MOUNT CLEMENS, MI 48043-1704
(586) 746-8159
(586) 307-3570
Mailing address
148 CANFIELD DR, MOUNT CLEMENS, MI 48043-1704
(586) 746-8159
(586) 307-3570

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
369448487-A
MI
Enumeration date
08/20/2015
Last updated
08/22/2015
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