Individual
DR. ANDREA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5200 WILLSON RD, SUITE 205, EDINA, MN 55424-1332
(952) 922-3010
(952) 920-2461
Mailing address
5200 WILLSON RD, SUITE 205, EDINA, MN 55424-1332
(952) 922-3010
(952) 920-2461
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4295
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2032501
PREFFERED ONE
MN
01
—
241M2HE
BCBS
MN
01
—
6120880
UBH
MN
Enumeration date
03/31/2007
Last updated
07/08/2007
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