Individual
JADA WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
174400000X
Specialist
Primary
OT2995
TN
174400000X
Specialist
OT3556
GA
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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