Individual
DIANE FAYE GIROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, NCTMB
Contact information
Practice address
1635 DAYTON AVE, # 3, ST PAUL, MN 55104-6277
(651) 631-1751
(651) 631-1751
Mailing address
1635 DAYTON AVE, # 3, ST PAUL, MN 55104-6277
(651) 631-1751
(651) 631-1751
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
NA
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2881635
MN CARE STATE TAX ID
MN
Enumeration date
06/13/2007
Last updated
07/08/2007
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