Individual
STEPHANIE GRINDELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DTR
Contact information
Practice address
5354 PARKDALE DR STE 200, MINNEAPOLIS, MN 55416-1617
(888) 364-5997
Mailing address
186 MAPLE ST, SAINT PAUL, MN 55106-5514
(218) 760-5670
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
86116519
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FM102071
MINNESOTA DEPARTMENT OF HEALTH
MN
Enumeration date
10/26/2020
Last updated
10/26/2020
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