Healthcare Provider Details

I. General information

NPI: 1932776796
Provider Name (Legal Business Name): VALERIE WRIGHT RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5779 GETWELL RD STE 3
SOUTHAVEN MS
38672-6347
US

IV. Provider business mailing address

5779 GETWELL RD STE 3
SOUTHAVEN MS
38672-6347
US

V. Phone/Fax

Practice location:
  • Phone: 662-510-6507
  • Fax: 662-510-6508
Mailing address:
  • Phone: 662-510-6507
  • Fax: 662-510-6508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: