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General NPI Number Information
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NPI Number | 1417638578
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Entity Type | Individual
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Provider Name | MR. MARK EDWIN WRIGHT
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Gender | Male
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 117 SPRATT ST STE B
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City | FORT MILL
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State | SC
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Zip | 29715-4111
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Country | US
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Telephone | 214-966-2579
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Fax |
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Provider Business Mailing Address
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Address Line | 2714 N DAVIDSON STREET
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City | CHARLOTTE
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State | NC
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Zip | 28205
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Country | US
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Telephone |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8727
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License Number State | SC
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