Provider Demographics
NPI:1053822155
Name:WRIGHT, MYCHEA
Entity Type:Individual
Prefix:
First Name:MYCHEA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 E PEARL ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-1115
Mailing Address - Country:US
Mailing Address - Phone:419-213-0415
Mailing Address - Fax:
Practice Address - Street 1:60 E PEARL ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-1115
Practice Address - Country:US
Practice Address - Phone:419-213-0415
Practice Address - Fax:419-213-0415
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker