Individual
MRS. LAURA LEIGH WOLOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D.E.
Contact information
Practice address
2740 PROSPERITY AVE STE 200, FAIRFAX, VA 22031-4354
(877) 511-4625
(703) 204-9006
Mailing address
2740 PROSPERITY AVE STE 200, FAIRFAX, VA 22031-4354
(877) 511-4625
(703) 204-9006
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
163WD0400X
Diabetes Educator Registered Nurse
Primary
20320510
VA
Other
Enumeration date
01/07/2010
Last updated
10/12/2020
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