Individual
MRS. JACQUETTA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
24463 W 10 MILE RD, SOUTHFIELD, MI 48033-2931
(248) 302-2201
Mailing address
24463 W 10 MILE RD, SOUTHFIELD, MI 48033-2931
(248) 302-2201
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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