Provider Demographics
NPI:1952702664
Name:WESCOTT, CAROLYN (RD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:WESCOTT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:FRASSICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-1022
Mailing Address - Country:US
Mailing Address - Phone:443-812-6296
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-1022
Practice Address - Country:US
Practice Address - Phone:443-812-6296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3675133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered