Individual
JEVON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(313) 587-6940
Mailing address
PO BOX 7048, DEARBORN, MI 48121-7048
(313) 587-6940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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