Individual
JANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2405 8TH ST S STE 200, MOORHEAD, MN 56560-4200
(218) 380-7357
(218) 331-4867
Mailing address
643 BIRCH LN, MOORHEAD, MN 56560-3226
(218) 236-1783
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11062
MN
1041C0700X
Clinical Social Worker
Primary
3799
ND
Other
Enumeration date
09/01/2017
Last updated
05/20/2021
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