Provider Demographics
NPI:1689208886
Name:DANZY, JOANNA STARKS (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:STARKS
Last Name:DANZY
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:S
Other - Last Name:DANZY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JOANNA LEIGH STARKS
Mailing Address - Street 1:5550 VANDERBILT DR N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3084
Mailing Address - Country:US
Mailing Address - Phone:225-505-0351
Mailing Address - Fax:
Practice Address - Street 1:5550 VANDERBILT DR N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3084
Practice Address - Country:US
Practice Address - Phone:225-505-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2677133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered