Individual
JENNIFER MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
11280 86TH AVE N, MAPLE GROVE, MN 55369-4510
(763) 400-7828
Mailing address
6600 FRANCE AVE S, EDINA, MN 55435-1805
(952) 835-2002
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
909
MN
Other
Enumeration date
12/09/2014
Last updated
12/10/2020
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