Individual
LISA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LMFT
Contact information
Practice address
1600 UNIVERSITY AVE W STE 12, SAINT PAUL, MN 55104-3952
(651) 379-5157
Mailing address
1600 UNIVERSITY AVE W STE 12, SAINT PAUL, MN 55104-3952
(651) 379-5157
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
LP5255
MN
106H00000X
Marriage & Family Therapist
1711
MN
Other
Enumeration date
11/26/2007
Last updated
07/13/2022
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