Provider Demographics
NPI:1093331118
Name:WRIGHT, KATHRINE MICHELLE (LSW)
Entity Type:Individual
Prefix:
First Name:KATHRINE
Middle Name:MICHELLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1064
Mailing Address - Country:US
Mailing Address - Phone:812-882-0509
Mailing Address - Fax:812-895-0585
Practice Address - Street 1:545 WILLOW ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1064
Practice Address - Country:US
Practice Address - Phone:812-882-0509
Practice Address - Fax:812-895-0585
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99099115A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker