Provider Information for 1609118637
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Ms. ALEXIS JOHNSON LMSW, CADC
Sex: Female
NPI: 1609118637
Last Updated: 2017-01-18
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1609118637 | ||||||||||||||||||||
| Enumeration Date | 2013-03-16 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 2609 ELECTRIC AVE STE A PORT HURON, MI 48060-6589 United States Phone: 810-357-1725 | Fax:810-982-9802 | ||||||||||||||||||||
| Primary Practice Address | 2609 ELECTRIC AVE STE A PORT HURON, MI 48060-6589 United States Phone: 810-357-1725 | Fax:810-982-9802 | ||||||||||||||||||||
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