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NPI Code Detail

MEDICARE: ANTONIA WRIGHT

MEDICARE: ANTONIA 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
1101YM0800XMental Health Counselor001169MO

General Provider Information

NPI Number : 1912983057
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONIA WRIGHT
Provider Business Mailing Address
First Line : 4149 PENNSYLVANIA AVE
Second Line : SUITE 205
City : KANSAS CITY
State : MO
Zip : 64111-3087
Country : US
Telephone Number : 816-531-6030
Fax Number : 913-648-4799
Provider Business Practice Location Address
First Line : 4149 PENNSYLVANIA AVE
Second Line : SUITE 205
City : KANSAS CITY
State : MO
Zip : 64111-3087
Country : US
Telephone Number : 816-531-6030
Fax Number : 913-648-4799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 07/08/2007

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Directions to “ ANTONIA WRIGHT ” Practice Location

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