Individual
MRS. MICHELE ANN GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1409 WILLOW ST, ST 220, MINNEAPOLIS, MN 55403-2269
(612) 240-4196
Mailing address
1409 WILLOW ST, ST 220, MINNEAPOLIS, MN 55403-2269
(612) 240-4196
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2244
MN
Other
Enumeration date
02/04/2007
Last updated
09/10/2007
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