Individual
MRS. MIRANDA JEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
15265 MINNETONKA BLVD., MINNETONKA, MN 55345
(952) 223-2506
(952) 443-2038
Mailing address
9346 OAK AVENUE, WACONIA, MN 55387
(952) 223-2506
(952) 443-2038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9263
MN
Other
Enumeration date
05/06/2014
Last updated
06/28/2019
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