Individual
STACEY LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1528 NORTHWAY DR, SAINT CLOUD, MN 56303-1255
(320) 252-0233
(320) 252-1421
Mailing address
1528 NORTHWAY DR, SAINT CLOUD, MN 56303-1255
(320) 252-0233
(320) 252-1421
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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