Individual
TRACIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
21885 DUNHAM RD, CLINTON TOWNSHIP, MI 48036-1030
(586) 469-5950
Mailing address
37698 CHARTER OAKS BLVD, CLINTON TOWNSHIP, MI 48036-2424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401016836
MI
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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