MEDICARE: BARBARA WRIGHT LMSW, LCSW, ACHP-SW

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	1041C0700X	Clinical Social Worker	7028	OK

General Provider Information

NPI Number	:	1790336097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA WRIGHT LMSW, LCSW, ACHP-SW

Provider Business Mailing Address
First Line	:	4 OAK PLACE RD
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74604-6052
Country	:	US
Telephone Number	:	580-304-2730
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 FAIRVIEW AVE
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-1931
Country	:	US
Telephone Number	:	580-762-9102
Fax Number	:

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

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	09/27/2019

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