Individual
HAYLEY MARIAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1123 GRAND AVE, SAINT PAUL, MN 55105-2885
(651) 262-6253
(651) 389-9176
Mailing address
1137 GRAND AVE, SAINT PAUL, MN 55105-2629
(651) 262-6253
(651) 389-9176
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305288
MN
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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