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Contact Information

HATTIE JOHNSON
17250 W 12 MILE RD STE 211A
SOUTHFIELD, MI48076-2123
 Phone: 248-508-2858
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Student Health

261QS1000X
Indicates primary specialty

NPI Profile & details for

NPI # 1790577179
Entity Organization
Organization subpart 1 Not specified
Enumeration date 05/21/2025
Last updated 05/21/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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