Individual
KARISA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1470 INDUSTRIAL AVE, ROCHESTER, MN 55901-2616
(507) 322-7750
Mailing address
1470 INDUSTRIAL AVE, ROCHESTER, MN 55901
(507) 322-7750
(507) 517-3055
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46193
MN
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588993091
—
MN
Enumeration date
05/15/2018
Last updated
12/29/2023
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