Individual
HEIDIE LISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD
Contact information
Practice address
3401 BRUNSWICK AVE S, ST LOUIS PARK, MN 55416-2307
(612) 245-0699
Mailing address
3401 BRUNSWICK AVE S, ST LOUIS PARK, MN 55416-2307
(612) 245-0699
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
984434
MN
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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