Individual
DIANE PATRICIA O'GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNS
Contact information
Practice address
7945 STONE CREEK DRIVE, SUITE 130, CHANHASSEN, MN 55317
(952) 241-4050
(952) 241-4049
Mailing address
7945 STONE CREEK DRIVE, SUITE 130, CHANHASSEN, MN 55317
(952) 241-4050
(952) 241-4049
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R0749465
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024042700
—
MN
01
—
642K4BA
BCBS
MN
Enumeration date
11/22/2006
Last updated
01/17/2012
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