Provider Demographics
NPI:1356859821
Name:HINDS, ANTOINETTE MICHELLE (RD)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:MICHELLE
Last Name:HINDS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6936 HANOVER PKWY APT 302
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2215
Mailing Address - Country:US
Mailing Address - Phone:347-408-5545
Mailing Address - Fax:
Practice Address - Street 1:6936 HANOVER PKWY APT 302
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2215
Practice Address - Country:US
Practice Address - Phone:240-200-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3181133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered