| NPI | 1669430237 |
|---|---|
| Former Name | LESLIE A JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3588) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: MN LP3588) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-07-08 |