Provider Demographics
NPI:1306443098
Name:MCCARTY, DARLA R (CPT, CES, PN2, MS)
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:R
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:CPT, CES, PN2, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7718 BENTWATER DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-4312
Mailing Address - Country:US
Mailing Address - Phone:315-681-1322
Mailing Address - Fax:
Practice Address - Street 1:7718 BENTWATER DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-4312
Practice Address - Country:US
Practice Address - Phone:315-681-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X
CO171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education