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Individual

STACY RYAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S.

Contact information

Practice address
7527 MITCHELL ROAD, 100, EDEN PRAIRIE, MN 55344
(952) 228-2282
(952) 224-2284
Mailing address
2115 COUNTY ROAD D E, SUITE B, MAPLEWOOD, MN 55109-5353
(651) 748-5019
(651) 773-7591

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2290
MN

Other

Enumeration date
11/05/2007
Last updated
09/27/2025
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