Individual
DIANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTERS OF SCIENCE
Contact information
Practice address
245 PITKIN ST, HIGHLAND PARK, MI 48203-3737
(313) 865-1500
Mailing address
29327 DEBBIE DR, CHESTERFIELD, MI 48051-3920
(619) 930-0413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/11/2015
Last updated
11/11/2015
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