Individual
KATHERINE FANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CSWOMCDE
Contact information
Practice address
841 MANITOU DR, SAINT LOUIS, MO 63119-1229
(303) 717-2972
Mailing address
1315 SAN JACINTO CT, SAINT LOUIS, MO 63139-3703
(303) 717-2972
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2012024505
MO
Other
Enumeration date
03/02/2016
Last updated
07/21/2022
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