Organization
ROBERT E. JOHNSON, INC.
Active
Other names
Robert E. Johnson, Licensed Psychologist
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDWARD JOHNSON M.A., L.P. (LICENSED PSYCHOLOGIST)
(651) 628-0947
Entity
Organization
Contact information
Practice address
2579 HAMLINE AVE N, SUITE D, ROSEVILLE, MN 55113-3186
(651) 628-0947
(651) 636-2922
Mailing address
2579 HAMLINE AVE N, SUITE D, ROSEVILLE, MN 55113-3186
(651) 628-0947
(651) 636-2922
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LP1796
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099347600
—
MN
01
—
1225134687
INDIVIDUAL NPI ALREADY ISSUED MEDICARE INFORMED US NEEDED GROUP ALSO
MN
Enumeration date
04/24/2008
Last updated
04/24/2008
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