Individual
MRS. SHANNON LAUREN GORAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CDCES
Contact information
Practice address
2380 N FERGUSON AVE STE 104, TUCSON, AZ 85712-2837
(520) 324-1010
(520) 324-0029
Mailing address
PO BOX 31235, TUCSON, AZ 85751-1235
(520) 324-4100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1045306
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095196
—
AZ
Enumeration date
05/23/2021
Last updated
09/13/2021
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