Provider Demographics
NPI:1316292550
Name:WREN, DANIELLE (RD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WREN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 JAMES PL
Mailing Address - Street 2:SUITE 306
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3445
Mailing Address - Country:US
Mailing Address - Phone:412-423-8837
Mailing Address - Fax:
Practice Address - Street 1:200 JAMES PL
Practice Address - Street 2:SUITE 306
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3445
Practice Address - Country:US
Practice Address - Phone:412-423-8837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004489133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered