MEDICARE: DR. JENNIFER BUGG WRIGHT PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	2670	CO
2	103T00000X	Psychologist	5331	MD
3	103T00000X	Psychologist	2670	CO
4	103TF0200X	Forensic Psychologist	2670	CO
5	103TH0100X	Health Service Psychologist	2670	CO
6	103TR0400X	Rehabilitation Psychologist	2670	CO
7	103TH0004X	Health Psychologist	5531	MD

General Provider Information

NPI Number	:	1295770758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER BUGG WRIGHT PSY.D.

Provider Business Mailing Address
First Line	:	12504 E LASALLE PL
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1924
Country	:	US
Telephone Number	:	303-257-6880
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 QUINCE ORCHARD BLVD STE Q
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-1676
Country	:	US
Telephone Number	:	303-257-6880
Fax Number	:	303-257-6880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/21/2022

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