Provider Demographics
NPI:1316583354
Name:WRIGHT, SHENICE (NMD)
Entity Type:Individual
Prefix:DR
First Name:SHENICE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7620 E MCKELLIPS RD, STE 4, PMB # 15
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257
Mailing Address - Country:US
Mailing Address - Phone:602-575-8869
Mailing Address - Fax:
Practice Address - Street 1:3141 S MCCLINTOCK DR STE 4
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5682
Practice Address - Country:US
Practice Address - Phone:602-575-8869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1806175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty