Provider Demographics
NPI:1134501331
Name:WRIGHT, KIMBERLY LOUISE (MS)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:LOUISE
Other - Last Name:BLACKWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1997 HIGHWAY 51 S
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-3630
Mailing Address - Country:US
Mailing Address - Phone:901-313-1151
Mailing Address - Fax:901-313-1125
Practice Address - Street 1:1997 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3630
Practice Address - Country:US
Practice Address - Phone:901-313-1151
Practice Address - Fax:901-313-1125
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health