Provider Demographics
NPI:1467845107
Name:WRIGHT, TATYANNA
Entity Type:Individual
Prefix:
First Name:TATYANNA
Middle Name:
Last Name:WRIGHT
Suffix:
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 1:1305 N STILES AVE
Mailing Address - Street 2:APT. 17F
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-2870
Mailing Address - Country:US
Mailing Address - Phone:405-801-7880
Mailing Address - Fax:
Practice Address - Street 1:5929 N. MAY
Practice Address - Street 2:SUITE 310
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3909
Practice Address - Country:US
Practice Address - Phone:405-801-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker