Provider Demographics
NPI:1144931122
Name:POPA, DANIELLA ILEANA (RD/LDN)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:ILEANA
Last Name:POPA
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E BAY ST STE 201K
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-2635
Mailing Address - Country:US
Mailing Address - Phone:317-702-3385
Mailing Address - Fax:
Practice Address - Street 1:215 E BAY ST STE 201K
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-2635
Practice Address - Country:US
Practice Address - Phone:317-702-3385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86146783133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty