Provider Demographics
NPI:1225300593
Name:WRIGHT, KELLY RICHWOOD (MA)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:RICHWOOD
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 BROADWAY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-4995
Mailing Address - Country:US
Mailing Address - Phone:831-392-1500
Mailing Address - Fax:831-392-1501
Practice Address - Street 1:1069 BROADWAY AVE STE 201
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-4995
Practice Address - Country:US
Practice Address - Phone:831-392-1500
Practice Address - Fax:831-392-1501
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor