Individual
MS. NICOLE DEBORAH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1114 5TH ST, HOWARD LAKE, MN 55349
(763) 350-6924
Mailing address
1114 5TH ST, HOWARD LAKE, MN 55349
(763) 350-6924
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
05/13/2010
Last updated
10/24/2013
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