Healthcare Provider Details

I. General information

NPI: 1780598300
Provider Name (Legal Business Name): CRISANTA MENDIBEL DARCY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 N 450 E
TOOELE UT
84074-9192
US

IV. Provider business mailing address

1217 N 450 E
TOOELE UT
84074-9192
US

V. Phone/Fax

Practice location:
  • Phone: 801-889-0841
  • Fax:
Mailing address:
  • Phone: 801-889-0841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5290864-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: