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Individual

DR. CYNTHIA LYNNE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
333 SMITH AVE N, MAIL ROUTE 60222, ST. PAUL, MN 55102
(651) 241-8565
(651) 241-7168
Mailing address
333 SMITH AVE N, MAIL ROUTE 60222, ST. PAUL, MN 55102
(651) 241-8565
(651) 241-7168

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3230
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2147165
MN
Enumeration date
10/14/2005
Last updated
03/11/2021
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