Provider Demographics
NPI:1336406982
Name:WRIGHT, H. THERESA (LDN)
Entity Type:Individual
Prefix:
First Name:H. THERESA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 DEKALB PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-2007
Mailing Address - Country:US
Mailing Address - Phone:610-275-3699
Mailing Address - Fax:
Practice Address - Street 1:2500 DEKALB PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-2007
Practice Address - Country:US
Practice Address - Phone:610-275-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000663133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered