Individual
CHANIQUE TACHELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8275 BINGHAM, DETROIT, MI 48228
(313) 655-4003
Mailing address
8275 BINGHAM, DETROIT, MI 48228
(313) 655-4003
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MI
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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