Individual
CANDACE RAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LADC
Contact information
Practice address
2230 COMO AVE, SAINT PAUL, MN 55108-1720
(612) 730-9429
Mailing address
2230 COMO AVE, SAINT PAUL, MN 55108-1720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
30874
MN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
30874
MN
Other
Enumeration date
06/23/2022
Last updated
09/27/2024
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