Individual
JUDY BERGSTROM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2450 RIVERSIDE AVENUE, MINNEAPOLIS, MN 55454
(612) 672-6000
Mailing address
1841 WOOD DUCK LANE, EXCELSIOR, MN 55331
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101241
MN
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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