Individual
MRS. JOY ELIZABETH INNISS-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CRC, CAAC, CCS
Contact information
Practice address
4646 JOHN R. ROAD, JOHN D. DINGELL VA MEDICAL CENTER - MENTAL HEALTH, DETROIT, MI 48201-2410
(313) 576-1000
(313) 576-1074
Mailing address
4646 JOHN R. ROAD, JOHNSON D. DINGELL VA MEDICAL CENTER - MENTAL HEALTH, DETROIT, MI 48201-2410
(313) 576-1000
(313) 576-1074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401007295
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366491136
MENTAL HEALTH
MI
Enumeration date
03/20/2007
Last updated
12/23/2009
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