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General NPI Number Information
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NPI Number | 1093946915
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Entity Type | Individual
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Provider Name | LATONYA CAREY-WRIGHT PSYD.
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Gender | Female
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 1900 E. MAIN STREET, BUILDING 98 ROOM 3118 DEPARTMENT OF VETERANS AFFAIRS VAMC
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City | DANVILLE
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State | IL
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Zip | 61832
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Country | US
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Telephone | 217-554-4541
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 E. MAIN STREET, BUILDING 98 RM 3118 DEPARTMENT OF VETERANS AFFAIRS VAMC
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City | DANVILLE
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State | IL
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Zip | 61832
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Country | US
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Telephone | 217-554-4541
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY003292
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY003292
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License Number State | GA
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