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1932618618
TERRY LYNN JOHNSON
GRAND RAPIDS, MI
NPI
1932618618
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-09-25
Last Update Date
2017-09-25
Business Address
TERRY LYNN JOHNSON
1939 S DIVISION AVE
GRAND RAPIDS, MI 49507
Phone number: 616-247-3815
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Mailing Address
TERRY LYNN JOHNSON
1939 S DIVISION AVE
GRAND RAPIDS, MI 49507
Phone number: 616-247-3815
Copy
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