Individual
KATHLEEN L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, LADC, CBIS
Contact information
Practice address
10990 95TH ST NE, OTSEGO, MN 55362-8149
(763) 329-7195
(952) 448-6047
Mailing address
500 MARSCHALL RD STE 300, SHAKOPEE, MN 55379-2690
(952) 856-3932
(952) 448-6047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302203
MN
Other
Enumeration date
06/06/2023
Last updated
05/15/2024
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