Individual
DR. JODI LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
(541) 830-7557
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
(701) 237-2642
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3266
OR
Other
Enumeration date
08/20/2015
Last updated
03/22/2022
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