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NPI Code Detail

MEDICARE: MRS. ASHLEY D JOHNSON MA, LMFT

MEDICARE: MRS. ASHLEY D JOHNSON MA, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1932469111
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY D JOHNSON MA, LMFT
Provider Business Mailing Address
First Line : 112 1ST ST W
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4002
Country : US
Telephone Number : 218-888-8032
Fax Number : 218-888-8033
Provider Business Practice Location Address
First Line : 112 1ST ST W
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4002
Country : US
Telephone Number : 218-888-8032
Fax Number : 218-888-8033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2012
Last Update Date : 03/01/2022

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