Individual
CHRISTINA LYNNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.L.P.
Contact information
Practice address
47818 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317-3373
(586) 323-3620
(586) 323-3568
Mailing address
47818 VAN DYKE AVENUE, SHELBY TOWNSHIP, MI 48317
(586) 323-3620
(586) 323-3568
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301013793
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028363
VALUE OPTIONS
MI
05
—
1705289
—
MI
01
—
20576
BCBSM SUBSTANCE ABUSE
MI
01
—
5266701
AETNA
MI
01
—
7509105060
BCBSM
MI
Enumeration date
08/12/2008
Last updated
07/01/2015
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