Individual
EVYNN MARIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LCSW
Contact information
Practice address
2033 KOLO RD, KILAUEA, HI 96754-5563
(231) 206-3686
Mailing address
3995 STAMFORD DR, NORTON SHORES, MI 49441-5037
(231) 206-3686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801094237
MI
Other
Enumeration date
06/06/2017
Last updated
10/20/2020
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