Provider Demographics
NPI:1093957136
Name:WRIGHT, CECIL BAKER IV (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:CECIL
Middle Name:BAKER
Last Name:WRIGHT
Suffix:IV
Gender:M
Credentials:PHD, BCBA
Other - Prefix:DR
Other - First Name:BAKER
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, BCBA
Mailing Address - Street 1:PO BOX 10827
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32302-2827
Mailing Address - Country:US
Mailing Address - Phone:850-443-8378
Mailing Address - Fax:850-521-1973
Practice Address - Street 1:4820 KERRY FOREST PKWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-0200
Practice Address - Country:US
Practice Address - Phone:508-521-0242
Practice Address - Fax:850-521-1973
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst