Individual
DEJA RENEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-1000
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-1000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012759A
IN
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/02/2022
Last updated
04/08/2025
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