Individual
MRS. STACY LEA JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4415 36 1/2 STREET WEST, ST. LOUIS PARK, MN 55416
(952) 927-9717
(952) 927-7687
Mailing address
4415 36 1/2 STREET WEST, ST. LOUIS PARK, MN 55416
(952) 927-9717
(952) 927-7687
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100740
MN
Other
Enumeration date
09/21/2006
Last updated
04/02/2012
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