Individual
TARA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
606 24TH AVE S FL 3, MINNEAPOLIS, MN 55454-1455
(612) 626-4939
(612) 273-7112
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
06/14/2024
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