Individual
MARY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1641 31ST AVE S, FARGO, ND 58103-5934
(701) 858-0115
(701) 852-1190
Mailing address
PO BOX 5007, MINOT, ND 58702-5007
(701) 858-0115
(701) 852-1190
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2001
ND
Other
Enumeration date
02/14/2008
Last updated
02/14/2008
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