Individual
AUDRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W MAIN ST, MIDLAND, MI 48640-5184
(989) 631-0241
Mailing address
2276 N SMITH ST, SANFORD, MI 48657-9479
(989) 708-1381
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012591
MI
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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