Provider Demographics
NPI:1164806402
Name:WRIGHT, DARREN I
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:WRIGHT
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15345 AVENUE OF THE ARBORS
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-8741
Mailing Address - Country:US
Mailing Address - Phone:724-816-1884
Mailing Address - Fax:
Practice Address - Street 1:15345 AVENUE OF THE ARBORS
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-8741
Practice Address - Country:US
Practice Address - Phone:724-816-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1256515101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool