Healthcare Provider Details

I. General information

NPI: 1649959347
Provider Name (Legal Business Name): FAITH WRIGHT RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CRESTWOOD EXECUTIVE CTR STE 500
SAINT LOUIS MO
63126-1948
US

IV. Provider business mailing address

50 CRESTWOOD EXECUTIVE CTR STE 500
SAINT LOUIS MO
63126-1948
US

V. Phone/Fax

Practice location:
  • Phone: 636-229-1977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2023027065
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: