Provider Demographics
NPI:1205402567
Name:STRYCULA, WENDY (CNS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:STRYCULA
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8103 BANNERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1292
Mailing Address - Country:US
Mailing Address - Phone:301-384-0928
Mailing Address - Fax:
Practice Address - Street 1:8103 BANNERWOOD CT
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1292
Practice Address - Country:US
Practice Address - Phone:301-384-0928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist