Healthcare Provider Details

I. General information

NPI: 1609626647
Provider Name (Legal Business Name): LEAH WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 03/25/2024
Certification Date: 03/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 SUGAR BUSH LN N
BROWNSBURG IN
46112-1894
US

IV. Provider business mailing address

366 SUGAR BUSH LN N
BROWNSBURG IN
46112-1894
US

V. Phone/Fax

Practice location:
  • Phone: 317-440-8692
  • Fax:
Mailing address:
  • Phone: 317-440-8692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: