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Individual

TARA DOHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2090 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 968-5201
Mailing address
1845 ONACREST CT, MAPLEWOOD, MN 55117-2329
(651) 214-3603

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3784
MN

Other

Enumeration date
05/31/2023
Last updated
06/16/2024
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