Individual
BEVERLY JEAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA.LP
Contact information
Practice address
5275 EDINA INDUSTRIAL BLVD STE 124, EDINA, MN 55439-2903
(952) 926-3412
(952) 926-3414
Mailing address
5275 EDINA INDUSTRIAL BLVD STE 124, EDINA, MN 55439-2903
(952) 926-3412
(952) 926-3414
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2076
MN
Other
Enumeration date
09/26/2006
Last updated
08/08/2019
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