Provider Demographics
NPI:1467961086
Name:WRIGHT, BETHANIE JO
Entity Type:Individual
Prefix:MS
First Name:BETHANIE
Middle Name:JO
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 1:43 WADSWORTH TER
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2570
Mailing Address - Country:US
Mailing Address - Phone:908-370-1697
Mailing Address - Fax:
Practice Address - Street 1:43 WADSWORTH TER
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2570
Practice Address - Country:US
Practice Address - Phone:908-370-1697
Practice Address - Fax:908-370-1697
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty