MRS. Mary Monica Russell, LRD, CDE
NPI #1912234071 in Fargo, North Dakota
Provider Information
- NPI Number
- 1912234071
- Entity Type
- Individual
- Name
- MRS. Mary Monica Russell, LRD, CDE
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dietitian, Registered
- Credential
- LRD, CDE
- Enumeration Date
- Nov 11, 2009
- Last Updated
- Nov 11, 2009
Practice Location
- Address
- 1702 EAST ROSE CREEK PARKWAY SOUTH
- City
- Fargo
- State
- North Dakota
- ZIP Code
- 58104-6834
- Phone
- (701) 239-4946
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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