Individual
ANNA MARIE GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
312 4TH AVE NE, MINNEAPOLIS, MN 55413-2044
(952) 826-9368
Mailing address
18015 W 82ND ST, EDEN PRAIRIE, MN 55347-2157
(952) 826-9368
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86144678
MN
Other
Enumeration date
08/05/2024
Last updated
09/17/2024
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