Individual
JA'LIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6516 FLORENCE LN, VAN BUREN TWP, MI 48111-5267
(313) 969-6134
Mailing address
6516 FLORENCE LN, VAN BUREN TWP, MI 48111-5267
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MI
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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