Individual
BONITA RAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
7206 FORESTVIEW LN N # 210, MAPLE GROVE, MN 55369-5581
(763) 201-1029
Mailing address
8817 INVERNESS TER, BROOKLYN PARK, MN 55443-1921
(763) 424-8866
(763) 424-8696
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
997
MN
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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