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General NPI Number Information
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NPI Number | 1598018541
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Entity Type | Organization
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Legal Business Name | WRIGHT PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 901 S GRETCHEN AVE
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City | CHANUTE
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State | KS
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Zip | 66720-2541
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Country | US
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Telephone | 620-433-5038
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Fax | 620-433-5527
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Provider Business Mailing Address
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Address Line | PO BOX 226
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City | CHANUTE
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State | KS
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Zip | 66720-0226
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Country | US
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Telephone | 620-433-5038
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Fax | 620-433-5527
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | SHAWNA DIANE WRIGHT
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Credential | PH.D.
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Telephone | 620-433-5038
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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 | 815
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1236
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License Number State | KS
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