Individual
JEANNE ADELAIDE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, BA, ICADC, LAC
Contact information
Practice address
8609 LYNDALE AVE S, SUITE 110, BLOOMINGTON, MN 55420-2754
(952) 358-1009
(952) 881-1093
Mailing address
8609 LYNDALE AVE S, SUITE 110, BLOOMINGTON, MN 55420-2754
(952) 358-1009
(952) 881-1093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300969
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
9605694
SD
Other
Enumeration date
03/09/2014
Last updated
05/04/2015
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