Individual
TIANA GUNNAR MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3250 W 66TH ST APT 548, EDINA, MN 55435-5514
(502) 382-0927
Mailing address
444 VICTORY AVE APT 307, SARTELL, MN 56377-4823
(320) 333-8226
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5072
MN
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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