Individual
HATTIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17250 W 12 MILE RD STE 211A, SOUTHFIELD, MI 48076-2123
(248) 508-2858
Mailing address
17250 W 12 MILE RD STE 211A, SOUTHFIELD, MI 48076-2123
(248) 508-2858
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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