Healthcare Provider Details

I. General information

NPI: 1942116835
Provider Name (Legal Business Name): AQUANETTA MARIE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42461 WALNUT ST
CLINTON TOWNSHIP MI
48036-3169
US

IV. Provider business mailing address

42461 WALNUT ST
CLINTON TOWNSHIP MI
48036-3169
US

V. Phone/Fax

Practice location:
  • Phone: 313-767-1083
  • Fax:
Mailing address:
  • Phone: 313-767-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number26111756-14114126
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: