Individual
THI TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6540 PENN AVE S, RICHFIELD, MN 55423-1143
(612) 866-3040
Mailing address
6445 LYNDALE AVE S APT 339, RICHFIELD, MN 55423-7563
(956) 579-8474
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
127049
MN
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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