Provider Demographics
NPI:1851781215
Name:WRIGHT, VALERIE MAE (CNS, LDN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MAE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6414 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5247
Mailing Address - Country:US
Mailing Address - Phone:240-418-4852
Mailing Address - Fax:443-288-4406
Practice Address - Street 1:6414 DOGWOOD RD
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-5247
Practice Address - Country:US
Practice Address - Phone:240-418-4852
Practice Address - Fax:443-288-4406
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD017206133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist