Individual
MADELINE NICAELA EMANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
(651) 645-5323
Mailing address
6725 YORK AVE S APT 341, EDINA, MN 55435-3226
(952) 607-7463
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/12/2021
Last updated
06/12/2021
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