Individual
MISS TRACEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14010 MONICA ST APT 23, DETROIT, MI 48238-2565
(313) 722-0084
Mailing address
14010 MONICA ST APT 23, DETROIT, MI 48238-2565
(313) 722-0084
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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