Individual
MRS. DALENA ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1932
(313) 576-1000
Mailing address
18837 GOLDWIN ST, SOUTHFIELD, MI 48075-7217
(313) 587-2174
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704275856
MI
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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