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General NPI Number Information
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NPI Number | 1679585285
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Entity Type | Organization
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Legal Business Name | GINNY WRIGHT, PH.D., P.C.
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 604 MOUNT VERNON AVE
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City | CHARLOTTE
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State | NC
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Zip | 28203-4538
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Country | US
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Telephone | 704-377-5003
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Fax | 704-342-9970
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Provider Business Mailing Address
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Address Line | 604 MOUNT VERNON AVE
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City | CHARLOTTE
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State | NC
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Zip | 28203-4538
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Country | US
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Telephone | 704-377-5003
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Fax | 704-342-9970
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GINNY WRIGHT
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Credential | PH.D.
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Telephone | 704-377-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1119
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License Number State | NC
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