Individual
MICHELLE A LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2165 WHITE BEAR AVE, MAIL STOP 31600A, MAPLEWOOD, MN 55109-2798
(651) 779-1500
(651) 770-3371
Mailing address
8100 34TH AVE S, MAIL STOP 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-5463
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2047
MN
Other
Enumeration date
04/07/2006
Last updated
07/08/2007
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