Individual
MAYA ALICIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
37450 SCHOOLCRAFT RD, LIVONIA, MI 48150-1082
(734) 458-4601
Mailing address
24671 PEMBROOKE DR, SOUTHFIELD, MI 48033-3159
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703114356
MI
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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