Individual
DEMARCO SHAUNTEZ JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
Mailing address
17499 W 13 MILE RD, SOUTHFIELD, MI 48076-1266
(131) 352-3555
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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