Provider Demographics
NPI:1083078794
Name:WRIGHT, LETITIA (LBSW)
Entity Type:Individual
Prefix:
First Name:LETITIA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9641 HARPER AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-2731
Mailing Address - Country:US
Mailing Address - Phone:313-961-7990
Mailing Address - Fax:
Practice Address - Street 1:9641 HARPER AVE
Practice Address - Street 2:#2
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-2731
Practice Address - Country:US
Practice Address - Phone:313-961-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802085097104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker