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NPI 1639636871

NPI 1639636871 : ARIANNE JOHNSTON : BROOKLYN PARK, MN

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General NPI Number Information
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    NPI Number           |    1639636871
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    Entity Type          |    Individual 
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    Provider Name        |    ARIANNE JOHNSTON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/25/2019
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    Last Update Date     |    02/25/2019
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Provider Practice Location Address
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    Address Line         |    8925 ZANE AVE N 
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    City                 |    BROOKLYN PARK
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    State                |    MN
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    Zip                  |    55443-1630
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    Country              |    US
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    Telephone            |    612-386-3459
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3395 PLYMOUTH RD 
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    City                 |    MINNETONKA
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    State                |    MN
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    Zip                  |    55305-3765
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    Country              |    US
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    Telephone            |    952-939-0396
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    3396
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    License Number State |    MN
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