| Detroit Health And Wellness, Pllc | |
|
1001 Woodward Ave Fl 5 Detroit MI 48226-1904 | |
| (313) 739-7836 | |
| (313) 557-1662 |
| Full Name | Detroit Health And Wellness, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1001 Woodward Ave Fl 5, Detroit, Michigan |
| Authorized Official Name and Position | Sandra K. Johnson (PSYCHOLOGIST/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3137397836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Detroit Health And Wellness, Pllc 8200 E Jefferson Ave Apt 1604 Detroit MI 48214-3978 Ph: (248) 766-3209 | Detroit Health And Wellness, Pllc 1001 Woodward Ave Fl 5 Detroit MI 48226-1904 Ph: (313) 739-7836 |
| NPI Number | 1306497318 |
|---|---|
| Provider Enumeration Date | 09/23/2019 |
| Last Update Date | 09/23/2019 |
| Medicare PECOS PAC ID | 5991132623 |
|---|---|
| Medicare Enrollment ID | O20200219000691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306497318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sandra K Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265656516 PECOS PAC ID: 6406746627 Enrollment ID: I20040319000184 |
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