MEDICARE: LAURA RUTH WRIGHT ED.D

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	103TC0700X	Clinical Psychologist	25008	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295777134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA RUTH WRIGHT ED.D

Provider Business Mailing Address
First Line	:	710 N 64TH ST
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-4387
Country	:	US
Telephone Number	:	254-772-8055
Fax Number	:	254-772-3019

Provider Business Practice Location Address
First Line	:	710 N 64TH ST
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-4387
Country	:	US
Telephone Number	:	254-772-8055
Fax Number	:	254-772-3019

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	09/18/2025

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