Corazon J Reyes, R.D.,L.D.
Individual provider Active NPI Registered Dietitian · Berkeley, MO
NPI 1053431825 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053431825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2001025465 (MO)
- Practice address
- 6065 Helen Ave
Berkeley, MO 63134-2013 - Phone
- (314) 522-6410
- Fax
- (314) 522-0821
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001025465 | MO | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2001025465 | MO | Yes |
Addresses
Primary practice location
6065 Helen Ave
Berkeley, MO 63134-2013
Mailing address
3973 Lockport Dr
Bridgeton, MO 63044-2116
Phone (314) 739-6332
Other providers in Berkeley, MO
- Sheila D Pearson
- Catherine Pedroley
- Karen Elisabeth Peters
- Lauren Pyatt
- Reliant in Home Health Services Inc
- Jonathan M Richert
- Pamela Jean Russell
- Patricia Ruzicka
- Omnia Salem
- Maliyha Sade Satterwhite
All providers in Berkeley, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.