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General NPI Number Information
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NPI Number | 1154640167
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Entity Type | Individual
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Provider Name | JEANETTE L WRIGHT LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 3810 WINCHESTER RD SOUTHEAST MENTAL HEALTH CENTER
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City | MEMPHIS
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State | TN
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Zip | 38118-6045
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Country | US
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Telephone | 901-369-1420
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Fax | 901-369-1433
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Provider Business Mailing Address
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Address Line | 5859 SHILOAH CV S
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-3054
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Country | US
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Telephone | 662-895-4945
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW7666
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License Number State | TN
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