Individual
ANISSA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
26715 GREENFIELD RD, SOUTHFIELD, MI 48076-4717
(702) 553-9088
Mailing address
20300 ROSELAND ST, SOUTHFIELD, MI 48076-2464
(702) 553-9088
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013662
MI
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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