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General NPI Number Information
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NPI Number | 1093512014
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Entity Type | Individual
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Provider Name | BREANNA WRIGHT LPC-A
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 2520 LONGVIEW ST STE 307
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City | AUSTIN
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State | TX
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Zip | 78705-4202
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Country | US
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Telephone | 512-607-9360
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Fax |
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Provider Business Mailing Address
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Address Line | 11803 ARGONNE FOREST TRL APT B
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City | AUSTIN
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State | TX
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Zip | 78759-2224
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Country | US
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Telephone | 530-524-4073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 97766
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License Number State | TX
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