Individual
JESSE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1342 BALDWIN ST, JENISON, MI 49428-8937
(231) 535-2822
Mailing address
2329 CENTER ST, BOYNE FALLS, MI 49713-9268
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/16/2026
Last updated
07/16/2026
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