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Allen Jerome Johnson
Addiction (Substance Use Disorder) Counselor in Prior Lake, Minnesota
NPI 1922424407

Allen Jerome Johnson is an Addiction (Substance Use Disorder) Counselor based in Bloomington, MN and is specialized in Addiction (Substance Use Disorder). Allen Jerome Johnson practices in Prior Lake, MN. The NPI Number for Allen Jerome Johnson is 1922424407 and holds a License No. 301018 (Minnesota).

The current practice location address for Allen Jerome Johnson is 14162 Commerce Ave Ne, Prior Lake, MN and can be reached out via phone at 952-447-1117.

Location: 14162 Commerce Ave Ne, Prior Lake, MN, 55420-5030
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922424407
Provider Name
Allen Jerome Johnson
Credential
Provider Entity Type
Individual
Gender
Male
Address
14162 Commerce Ave Ne, Prior Lake, MN, 55420-5030
Phone Number
952-447-1117
Fax Number
Provider Enumeration Date
03/09/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
14162 Commerce Ave Ne
City
Prior Lake
State
Minnesota
Zip
55372-1480
Phone Number
952-447-1117
Fax Number
person
Provider Business Mailing Address Details
Address
14162 Commerce Ave Ne
City
Prior Lake
State
Minnesota
Zip
55372-1480
Phone Number
952-447-1117
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
301018 (Minnesota)
Definition
Definition to come...
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