Individual
MARY JOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 WOODDALE DR STE A, WOODBURY, MN 55125-2933
(651) 738-9888
Mailing address
2101 WOODDALE DR STE A, WOODBURY, MN 55125-2933
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10171
MN
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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