Individual
THERESE ANN IDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1400 JACKSON ST, DENVER, CO 80206
(303) 388-4461
(303) 270-2174
Mailing address
1400 JACKSON ST, DENVER, CO 80206-2762
(303) 388-4461
(303) 270-2174
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
505475
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
505475
REG#
CO
Enumeration date
03/07/2013
Last updated
02/26/2019
About Stedi
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