Individual
MS. AMY RENE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MAT, LPC, TLS
Contact information
Practice address
38267 FERNHILL CT, CLINTON TOWNSHIP, MI 48038-3422
(248) 930-2909
Mailing address
38267 FERNHILL CT, CLINTON TOWNSHIP, MI 48038-3422
(248) 930-2909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3329608
MI
101YP2500X
Professional Counselor
3329608
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3329608
—
MI
Enumeration date
06/03/2013
Last updated
01/21/2021
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