Individual
KJELLANN LOE-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.A.P.C.
Contact information
Practice address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Mailing address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
782-4-1-14A
ND
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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