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Individual

JOHNNY CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
700 E GRAND BLVD, DETROIT, MI 48207-2526
(313) 702-1301
Mailing address
18601 GREELEY ST, HIGHLAND PARK, MI 48203-2191
(313) 808-5602

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MI
175T00000X
Peer Specialist
MI
175T00000X
Peer Specialist

Other

Enumeration date
03/14/2024
Last updated
03/20/2024
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