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Individual
LISA E WRIGHT
Active
Individual
LISA E WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005258
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164005258
STATE OF ILLINOIS LICENSE
IL
Enumeration date
06/25/2010
Last updated
06/25/2010
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