Individual
ANNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
2063 EXCALIBUR LN, NORTH MANKATO, MN 56003-4422
(507) 508-9111
Mailing address
2063 EXCALIBUR LN, NORTH MANKATO, MN 56003-4422
(507) 508-9111
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
62353
MN
Other
Enumeration date
09/10/2021
Last updated
05/18/2023
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