Provider Demographics
NPI:1255892543
Name:ANTONY, DARCIE JO (RD, CD)
Entity type:Individual
Prefix:MRS
First Name:DARCIE
Middle Name:JO
Last Name:ANTONY
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 SOUTH 7TH ST
Mailing Address - Street 2:DIETITIAN'S OFFICE 4TH FLOOR
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802
Mailing Address - Country:US
Mailing Address - Phone:812-237-1161
Mailing Address - Fax:812-242-6555
Practice Address - Street 1:3901 SOUTH 7TH ST
Practice Address - Street 2:DIETITIAN'S OFFICE 4TH FLOOR
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802
Practice Address - Country:US
Practice Address - Phone:812-237-1161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered