Healthcare Provider Details

I. General information

NPI: 1679348304
Provider Name (Legal Business Name): TANYA ANNETTE WRIGHT DSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 09/29/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PENNSYLVANIA AVE, UNIT LLC
WILMINGTON DE
19806-1392
US

IV. Provider business mailing address

2300 PENNSYLVANIA AVENUE UNIT LLC
WILMINGTON DE
19806-1392
US

V. Phone/Fax

Practice location:
  • Phone: 302-213-6158
  • Fax: 855-530-2764
Mailing address:
  • Phone: 302-213-6158
  • Fax: 855-530-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33828
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0013027
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: