| NPI | 1003988569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA JOHNSON Sole Practitioner 651-644-4930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 3958) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |