Individual
JEANINE LYNN CAMPBELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
5229 CASS AVE, DETROIT, MI 48202-3930
(313) 577-2840
Mailing address
1092 BEACONSFIELD AVE APT 2S, GROSSE POINTE PARK, MI 48230-2014
(425) 894-6978
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6352000958
MI
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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