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NPI Code Detail

MEDICARE: JENNIFER S. JOHNSON MARRIAGE AND FAMILY LLC

MEDICARE: JENNIFER S. JOHNSON MARRIAGE AND FAMILY LLC
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 : 1790135713
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER S. JOHNSON MARRIAGE AND FAMILY LLC
Provider Business Mailing Address
First Line : 7036 HIGHOVER CT S
Second Line :
City : CHANHASSEN
State : MN
Zip : 55317-7569
Country : US
Telephone Number : 612-210-1748
Fax Number :
Provider Business Practice Location Address
First Line : 8640 EAGLE CREEK CIR
Second Line :
City : SAVAGE
State : MN
Zip : 55378-4400
Country : US
Telephone Number : 952-746-7664
Fax Number : 952-224-4867
Authorized Official
Title or Position : MARRIAGE AND FAMILY THERAPIST
Name : MS. JENNIFER SUSAN JOHNSON
Credential : LMFT
Telephone Number : 612-210-1748
Provider Enumeration Date : 06/21/2016
Last Update Date : 06/21/2016

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Directions to “JENNIFER S. JOHNSON MARRIAGE AND FAMILY LLC ” Practice Location

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