Individual
CHANEL GEORGETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
44899 CENTRE CT STE 101, CLINTON TOWNSHIP, MI 48038
(586) 792-1654
Mailing address
1463 BEACONSFIELD AVE APT 2N, GROSSE POINTE PARK, MI 48230-1087
(586) 359-5269
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401018436
MI
101YP2500X
Professional Counselor
6401016390
MI
Other
Enumeration date
11/24/2017
Last updated
10/07/2020
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