MEDICARE: MICHEL L WRIGHT SLP

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	235Z00000X	Speech-Language Pathologist	3011	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588815831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHEL L WRIGHT SLP

Provider Business Mailing Address
First Line	:	420 GENERAL SOMERVELL ST NE
Second Line	:	HATHORNE ES
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123
Country	:	US
Telephone Number	:	505-299-0796
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 GENERAL SOMERVELL ST NE
Second Line	:	HATHORNE ES
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-1150
Country	:	US
Telephone Number	:	505-299-0796
Fax Number	:

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

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	10/06/2008

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Directions to “ MICHEL L WRIGHT SLP” Practice Location

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