Healthcare Provider Details

I. General information

NPI: 1891334751
Provider Name (Legal Business Name): ALECIA WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2019
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60916 MCMULLIN DR
BEND OR
97702-9005
US

IV. Provider business mailing address

60916 MCMULLIN DR
BEND OR
97702-9005
US

V. Phone/Fax

Practice location:
  • Phone: 541-390-1781
  • Fax:
Mailing address:
  • Phone: 541-390-1781
  • Fax: 430-255-5054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberABA-B-10227372
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number9999999999
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBEH-001638
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: