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Individual

RENAYE WYGANOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3653
(651) 653-2100
Mailing address
816 GARCEAU LN, VADNAIS HEIGHTS, MN 55127-7145
(651) 238-4558

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2138
MN

Other

Enumeration date
08/31/2015
Last updated
08/31/2015
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