Individual
MS. PATRICIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
1485 81ST AVE NE, SPRING LAKE PARK, MN 55432-2111
(763) 780-3036
(763) 780-0784
Mailing address
26139 GALEN DR, WYOMING, MN 55092-9341
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1019
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168059
UCARE
MN
01
—
53G98JO
BCBS
MN
01
—
62-55393
MEDICA
MN
01
—
HP38775
HEALTH PARTNERS
MN
Enumeration date
11/14/2006
Last updated
07/08/2007
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