Provider Demographics
NPI:1225578388
Name:WRIGHT, BETTY II
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:WRIGHT
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-0092
Mailing Address - Country:US
Mailing Address - Phone:225-326-7257
Mailing Address - Fax:
Practice Address - Street 1:1719 MERRILL DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4009
Practice Address - Country:US
Practice Address - Phone:501-663-2209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator