Healthcare Provider Details

I. General information

NPI: 1932718871
Provider Name (Legal Business Name): MICHELLE WRIGHT SIGN LANGUAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W WALNUT ST
GARDENA CA
90248-3103
US

IV. Provider business mailing address

105 W WALNUT ST
GARDENA CA
90248-3103
US

V. Phone/Fax

Practice location:
  • Phone: 310-977-9829
  • Fax:
Mailing address:
  • Phone: 310-977-9829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: