Provider Demographics
NPI:1326371162
Name:WRIGHT, KAREN BOGAN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:BOGAN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMSW
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 310
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48764-0310
Mailing Address - Country:US
Mailing Address - Phone:989-362-8636
Mailing Address - Fax:989-362-7800
Practice Address - Street 1:1199 HARRIS AVE
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9681
Practice Address - Country:US
Practice Address - Phone:989-362-8636
Practice Address - Fax:989-362-7800
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010350831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical