Provider Demographics
NPI:1225528086
Name:WRIGHT-WILSON, GRACE RACHEL (LIFESTYLE COACH)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:RACHEL
Last Name:WRIGHT-WILSON
Suffix:
Gender:F
Credentials:LIFESTYLE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4119
Mailing Address - Country:US
Mailing Address - Phone:727-545-4545
Mailing Address - Fax:
Practice Address - Street 1:8900 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4119
Practice Address - Country:US
Practice Address - Phone:727-545-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator