Individual
KAREN DIANE DOUGHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS, LDN
Contact information
Practice address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 626-3000
Mailing address
4544 MELLUM AVE NE, SAINT MICHAEL, MN 55376-8438
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
N185
MN
Other
Enumeration date
04/27/2006
Last updated
07/08/2007
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