Most Relevant Information
Provider Data
| NPI Number: | 1003562018 |
| Provider Name: | MARYA M JOHANNESON MA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/28/2022 |
| Last Updated: | 02/28/2022 |
Provider Practice Location
6001 EGAN DR STE 197
SAVAGE
MN
553782099
Practice Location Phone/Fax
| Phone: | 9525922200 |
| Fax: |
Provider Mailing Location
482 WILDERNESS DR
CHASKA
MN
553181577
Provider Mailing Phone/Fax
| Phone: | 9522927459 |
| Fax: |