Provider Demographics
NPI:1184289431
Name:WRIGHT, COURTNEY MARIE (RD, LD, CPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RD, LD, CPT
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:BUTTERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD, CPT
Mailing Address - Street 1:4005 HARRISON AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2237
Mailing Address - Country:US
Mailing Address - Phone:330-413-1361
Mailing Address - Fax:
Practice Address - Street 1:7982 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-6930
Practice Address - Country:US
Practice Address - Phone:330-499-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7290133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered