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Individual

LISA L JOHNSON TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LP

Contact information

Practice address
1751 SOUTHCROSS DR W, BURNSVILLE, MN 55306-7012
(952) 892-7690
(952) 898-4930
Mailing address
1751 SOUTHCROSS DR W, BURNSVILLE, MN 55306-7012
(952) 892-7690
(952) 898-4930

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3787
MN

Other

Enumeration date
11/03/2006
Last updated
07/28/2014
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