Provider Demographics
NPI:1891120994
Name:DADDS, MARCIA L (MS, RDN)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:L
Last Name:DADDS
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TAMPA CIR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1819
Mailing Address - Country:US
Mailing Address - Phone:757-603-3557
Mailing Address - Fax:
Practice Address - Street 1:501 PRINCE GEORGE ST
Practice Address - Street 2:SUITE 308
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3664
Practice Address - Country:US
Practice Address - Phone:757-603-3557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-08
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist