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Individual

JENNIFER SUSAN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1772 STEIGER LAKE LN, #220, VICTORIA, MN 55386-7723
(952) 443-4600
Mailing address
7036 HIGHOVER CT S, CHANHASSEN, MN 55317-7569
(612) 210-1748
(952) 470-5175

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
09/17/2012
Last updated
09/17/2012
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