Therese Picasso-Edwards, RD
Individual provider Active NPI Registered Dietitian · Red Lodge, MT
NPI 1992917686 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992917686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 495 (MT)
- Practice address
- 600 W 21St St
Red Lodge, MT 59068 - Phone
- (406) 446-2345
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070809000250 | MT | Practitioner - Registered Dietitian Or Nutrition Professional | 6901997659 | Practice locations: Red Lodge, MT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 495 | MT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Picasso Health & Nutrition | Dietitian, Registered | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 495 | MT | Yes |
Addresses
Primary practice location
600 W 21St St
Red Lodge, MT 59068
Mailing address
2 Snowy LN.
Red Lodge, MT 59068-9645
Other providers in Red Lodge, MT
- William B. Oley
- Palisades Counseling Services
- Palisades Counseling, LLC
- Sarah Pedone
- Picasso Health & Nutrition
- Fred Wayne Pickering
- Kathleen Quinn Porco
- Amy Nicole Puett
- Red Lodge Drug Co Inc
- Red Lodge Public Schools
All providers in Red Lodge, MT · Registered Dietitian in Montana
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.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.