Individual
MS. LYNNE ELLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LP
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 828-7379
(218) 828-7390
Mailing address
4068 GREEN GABLES RD, BRAINERD, MN 56401-7946
(218) 829-6687
(218) 829-9555
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2864
MN
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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