Individual
MARIE ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9065 LYNDALE AVE S, BLOOMINGTON, MN 55420-3502
(952) 395-3326
Mailing address
8051 33RD AVE S UNIT 169, BLOOMINGTON, MN 55425-5003
(704) 746-2969
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
963635080
UNITEDHEALTHCARE
—
Enumeration date
05/14/2019
Last updated
07/17/2024
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