Elaine K Johnson Ma LP Ladc Pllc

NPI #1063234268 in Shoreview, Minnesota

Provider Information

NPI Number: 1063234268
Entity Type: Organization
Organization Name: Elaine K Johnson Ma LP Ladc Pllc
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 29, 2024
Last Updated: Oct 29, 2024

Practice Location

Address: 521 TANGLEWOOD DR
City: Shoreview
State: Minnesota
ZIP Code: 55126-2016
Phone: (612) 801-5826

Authorized Official

Name: ELAINE JOHNSON
Title: OWNER
Phone: (612) 801-5826

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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