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Individual

MADELINE BAKER JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPCC

Contact information

Practice address
21000 ROGERS DR STE 200, ROGERS, MN 55374-4926
(763) 291-5505
(763) 657-0819
Mailing address
3659 MAIN ST NE, MINNEAPOLIS, MN 55418-1133
(847) 525-8852

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2541
MN

Other

Enumeration date
07/20/2020
Last updated
07/20/2020
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