MEDICARE: VALERIE MAE WRIGHT CNS, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist	017206	MD

General Provider Information

NPI Number	:	1851781215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE MAE WRIGHT CNS, LDN

Provider Business Mailing Address
First Line	:	6414 DOGWOOD RD
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-5247
Country	:	US
Telephone Number	:	240-418-4852
Fax Number	:	443-288-4406

Provider Business Practice Location Address
First Line	:	6414 DOGWOOD RD
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-5247
Country	:	US
Telephone Number	:	240-418-4852
Fax Number	:	443-288-4406

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2015
Last Update Date	:	01/23/2015

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