Individual
ELLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4165 E LIPPINCOTT BLVD, BURTON, MI 48519
(810) 744-1883
Mailing address
4165 E LIPPINCOTT BLVD, BURTON, MI 48519
(810) 744-1883
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
EJ008605
MI
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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