Individual
EBONY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26360 BERG RD APT 215, SOUTHFIELD, MI 48033-5377
(313) 848-3100
Mailing address
26360 BERG RD APT 215, SOUTHFIELD, MI 48033-5377
(313) 848-3100
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/11/2025
Last updated
01/11/2025
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