Provider Demographics
NPI:1952437717
Name:WAINWRIGHT, LYDIA E (MAC, LAC, CAA)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:E
Last Name:WAINWRIGHT
Suffix:
Gender:F
Credentials:MAC, LAC, CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 TWO RIVERS DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2677
Mailing Address - Country:US
Mailing Address - Phone:443-474-3631
Mailing Address - Fax:410-874-0131
Practice Address - Street 1:86 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3008
Practice Address - Country:US
Practice Address - Phone:443-474-3631
Practice Address - Fax:410-874-0131
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01294171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist