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Individual

HEATHER J JOHNSON

Active
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Individual

HEATHER J JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TC1900X
Counseling Psychologist
Primary
5388
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
174658000
MN
Enumeration date
06/07/2010
Last updated
02/11/2019
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