Provider Information for 1164997474
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MAGGIE FLORENCE JOHNSON LPCC
Sex: Female
NPI: 1164997474
Last Updated: 2018-12-20
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1164997474 | ||||||||
| Enumeration Date | 2018-10-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6453 375TH ST NORTH BRANCH, MN 55056-5630 United States Phone: 651-235-7740 | Fax: | ||||||||
| Primary Practice Address | 38780 8TH AVE STE C NORTH BRANCH, MN 55056-6696 United States Phone: 763-227-7223 | Fax: | ||||||||
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