Healthcare Provider Details

I. General information

NPI: 1689411480
Provider Name (Legal Business Name): DIANE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 30TH ST NW
CANTON OH
44709-2902
US

IV. Provider business mailing address

3806 KAISER AVE NE
CANTON OH
44705-2720
US

V. Phone/Fax

Practice location:
  • Phone: 330-438-2400
  • Fax:
Mailing address:
  • Phone: 330-415-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: