Provider Demographics
NPI:1417736828
Name:WRIGHT, ALICIA LAUREN (RD, LDN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LAUREN
Last Name:WRIGHT
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 1:999 SW 1ST AVE APT 2512
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3489
Mailing Address - Country:US
Mailing Address - Phone:631-316-7451
Mailing Address - Fax:
Practice Address - Street 1:41 JOHN ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2932
Practice Address - Country:US
Practice Address - Phone:631-204-3375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86371085133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered