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General NPI Number Information
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NPI Number | 1346593936
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Entity Type | Individual
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Provider Name | JOHN BRYON WRIGHT LMHC
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Gender | Male
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 2901 W OAKLAND PARK BLVD SUITE A-1
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1243
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Country | US
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Telephone | 954-931-9165
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Fax | 954-462-4214
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Provider Business Mailing Address
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Address Line | 508 NE 16TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-1182
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Country | US
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Telephone | 954-931-9165
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Fax | 954-462-4214
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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 | MH2492
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License Number State | FL
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