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Individual

LAURA J. JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
410 E 48TH ST STE 2, MINNEAPOLIS, MN 55419
(612) 747-1325
Mailing address
5047 30TH AVE S, MINNEAPOLIS, MN 55417-1309
(612) 747-1325

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19191
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100263198
MN
Enumeration date
01/20/2010
Last updated
05/15/2018
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