Individual
KATHERINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
130 WABASHA ST S, SUITE 90, SAINT PAUL, MN 55107-1819
(651) 925-5531
(651) 450-2221
Mailing address
2833 MARYLAND AVE S, ST LOUIS PARK, MN 55426-3205
(651) 925-5531
(651) 450-2221
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20684
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M520025000
UMPI
MN
Enumeration date
10/14/2014
Last updated
10/14/2014
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