Individual
BETTY J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(800) 584-9226
Mailing address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(800) 584-9226
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300372
MN
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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