Individual
MINDY MARIE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD, CD
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(763) 504-4100
Mailing address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(763) 504-4100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3218-29
WI
133V00000X
Registered Dietitian
3979
MN
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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