Individual
MRS. MICHELLE JOHNSON-MASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6418 DEANS HILL RD, BERRIEN CENTER, MI 49102-8713
(269) 815-5500
(269) 815-5373
Mailing address
6418 DEANS HILL RD, BERRIEN CENTER, MI 49102-8713
(269) 815-5500
(269) 815-5373
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
680193354
MI
104100000X
Social Worker
6801093354
MI
Other
Enumeration date
07/06/2016
Last updated
07/13/2016
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