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NPI Code Detail

MEDICARE: YVONNE FELDER-JOHNSON MA

MEDICARE:   YVONNE  FELDER-JOHNSON  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401011927MI
2106S00000XBehavior TechnicianMI

General Provider Information

NPI Number : 1366740292
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVONNE FELDER-JOHNSON MA
Provider Business Mailing Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number :
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2011
Last Update Date : 11/28/2023

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Directions to “ YVONNE FELDER-JOHNSON MA” Practice Location

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