Doctor Name: | MRS. KARLIANN K JOHNSON |
NPI Number: | 1174802318 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC |
License Number: | 1076 |
Business Practice Address: | 1704 Belsly Blvd Moorhead, MN - 565605274 |
Business Phone Number: | 2182338068 |
Business Fax Number: | |
Mailing Address: | 862 36th Ave E, #211 WEST FARGO |
State: | ND |
Postal Code: | 580787922 |
Phone Number: | 2188311304 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2011 |
NPI Last Update Date: | 10/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1076 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |