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General NPI Number Information
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NPI Number | 1750754578
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Entity Type | Organization
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Legal Business Name | PATRICIA M WRIGHT PHD &ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 6928 COBBLESTONE BLVD SUITE 202
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City | SOUTHAVEN
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State | MS
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Zip | 38672-8300
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Country | US
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Telephone | 662-892-2885
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Fax | 662-892-2889
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Provider Business Mailing Address
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Address Line | 6928 COBBLESTONE BLVD SUITE 202
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City | SOUTHAVEN
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State | MS
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Zip | 38672-8300
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Country | US
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Telephone | 662-892-2885
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Fax | 662-892-2889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICIA M WRIGHT
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Credential | PSYCHOLOGIST
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Telephone | 662-892-2885
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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 | 33519
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License Number State | MS
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