Provider Demographics
NPI:1063651578
Name:WRIGHT, TERUKO MICHELLE (LMBT,NCTMB,CNA)
Entity Type:Individual
Prefix:
First Name:TERUKO
Middle Name:MICHELLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMBT,NCTMB,CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 WATERFORD CLUB XING
Mailing Address - Street 2:#228
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7814
Mailing Address - Country:US
Mailing Address - Phone:919-785-5066
Mailing Address - Fax:
Practice Address - Street 1:4811 WATERFORD CLUB XING
Practice Address - Street 2:#228
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7814
Practice Address - Country:US
Practice Address - Phone:919-785-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-08
Last Update Date:2009-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07879225700000X
NC300931374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide