Individual
JANE JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
505 12TH AVE WEST, SUITE 1, VIRGINIA, MN 55792
(218) 749-2877
(218) 749-6033
Mailing address
505 S 12TH AVE W STE 1, VIRGINIA, MN 55792-2001
(218) 749-2877
(218) 749-6033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304167
MN
Other
Enumeration date
08/30/2017
Last updated
07/21/2022
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