Individual
TARA MITRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
16620 40TH AVE N, MINNEAPOLIS, MN 55446-2687
(763) 242-4624
Mailing address
16620 40TH AVE N, MINNEAPOLIS, MN 55446-2687
(763) 242-4624
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2860
MN
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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