MEDICARE: MAURICE WRIGHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1023418803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICE WRIGHT

Provider Business Mailing Address
First Line	:	2121 N POST RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73141-4223
Country	:	US
Telephone Number	:	405-758-2420
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 N POST RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73141-4223
Country	:	US
Telephone Number	:	405-758-2420
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2014
Last Update Date	:	08/28/2014

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