Provider Demographics
NPI:1093946915
Name:CAREY-WRIGHT, LATONYA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LATONYA
Middle Name:
Last Name:CAREY-WRIGHT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E. MAIN STREET, BUILDING 98 RM 3118
Mailing Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS VAMC
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832
Mailing Address - Country:US
Mailing Address - Phone:217-554-4541
Mailing Address - Fax:
Practice Address - Street 1:1900 E. MAIN STREET, BUILDING 98 ROOM 3118
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS VAMC
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832
Practice Address - Country:US
Practice Address - Phone:217-554-4541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003292103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical