Individual
KIANA KIMMJO JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18643 JONESBORO CT, LAKEVILLE, MN 55044-6500
(612) 708-9043
Mailing address
18643 JONESBORO CT, LAKEVILLE, MN 55044-6500
(612) 708-9043
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305587
MN
Other
Enumeration date
01/04/2020
Last updated
01/04/2020
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