Provider Demographics
NPI:1316209224
Name:WRIGHT, MICHELE A (MSED)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MSED
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 366
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:NY
Mailing Address - Zip Code:12197-0366
Mailing Address - Country:US
Mailing Address - Phone:607-397-8843
Mailing Address - Fax:
Practice Address - Street 1:9 ELM ST.
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:NY
Practice Address - Zip Code:12197-0366
Practice Address - Country:US
Practice Address - Phone:607-397-8843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist