Provider Demographics
NPI:1093004855
Name:KIMBERLY WRIGHT, PH.D., P.L.L.C.
Entity Type:Organization
Organization Name:KIMBERLY WRIGHT, PH.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-509-6591
Mailing Address - Street 1:3295 N DRINKWATER BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6437
Mailing Address - Country:US
Mailing Address - Phone:602-509-6591
Mailing Address - Fax:480-820-0239
Practice Address - Street 1:3295 N DRINKWATER BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6437
Practice Address - Country:US
Practice Address - Phone:602-509-6591
Practice Address - Fax:480-820-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3047103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ867723Medicaid
AZ867723Medicaid