Individual
CARRIE M REYNOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
14500 99TH AVE N, MAPLE GROVE, MN 55369-4730
(763) 898-1000
Mailing address
14500 99TH AVE N # THAVEN, MAPLE GROVE, MN 55369-4730
(763) 898-1000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2851
MN
Other
Enumeration date
10/29/2009
Last updated
12/11/2018
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