Healthcare Provider Details

I. General information

NPI: 1487257077
Provider Name (Legal Business Name): KECIA WRIGHT COUNSELING AND COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 CRAIN HWY STE 510
WALDORF MD
20601-2819
US

IV. Provider business mailing address

3500 TWINBROOK DR
WALDORF MD
20603-4087
US

V. Phone/Fax

Practice location:
  • Phone: 240-216-2713
  • Fax:
Mailing address:
  • Phone: 240-216-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KECIA WRIGHT
Title or Position: PRESIDENT
Credential:
Phone: 240-216-2713