Individual
DANIEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1499 66TH AVE NE, FRIDLEY, MN 55432-4766
(612) 619-0197
Mailing address
1499 66TH AVE NE, FRIDLEY, MN 55432-4766
(612) 619-0197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
102L00000X
Psychoanalyst
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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