Individual
TARA TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3312 FOREST HILL SCHOOL RD, MILLSTADT, IL 62260-3116
(314) 454-4204
Mailing address
3312 FOREST HILL SCHOOL RD, MILLSTADT, IL 62260-3116
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
2001026850
MO
Other
Enumeration date
11/10/2016
Last updated
11/10/2016
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