Individual
MARYA M JOHANNESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6001 EGAN DR STE 197, SAVAGE, MN 55378-2099
(952) 592-2200
Mailing address
482 WILDERNESS DR, CHASKA, MN 55318-1577
(952) 292-7459
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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