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Individual

MR. TIMOTHY ROGER JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA LMFT

Contact information

Practice address
217 INDUSTRIAL DR SW, WILLMAR, MN 56201
(320) 905-0795
(320) 200-7480
Mailing address
PO BOX 284, WILLMAR, MN 56201-0284
(320) 905-0795
(320) 205-0030

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1071
MN
106H00000X
Marriage & Family Therapist
Primary
1071
MN

Other

Enumeration date
10/11/2006
Last updated
06/08/2018
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