Individual
DR. DONNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LP
Contact information
Practice address
1919 UNIVERSITY AVE W STE 200, SAINT PAUL, MN 55104-3435
(651) 266-7999
Mailing address
1057 COBB RD, SHOREVIEW, MN 55126-8121
(612) 803-3737
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3958
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016381
P1
MN
01
—
122753
UC
MN
01
—
134814
CP
MN
01
—
26291
HP
MN
05
—
292827200
—
MN
01
—
41Q23JO
BCBS
MN
01
—
61-53007
UBH
FM
Enumeration date
07/27/2006
Last updated
10/09/2017
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