Provider Demographics
NPI:1497110449
Name:WRIGHT, LATANYA NICOLE
Entity Type:Individual
Prefix:MS
First Name:LATANYA
Middle Name:NICOLE
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 1:1640 WASHINGTON ST
Mailing Address - Street 2:HEARTH, INC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3380
Mailing Address - Country:US
Mailing Address - Phone:617-369-1559
Mailing Address - Fax:617-369-1566
Practice Address - Street 1:1640 WASHINGTON ST
Practice Address - Street 2:HEARTH, INC
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-3380
Practice Address - Country:US
Practice Address - Phone:617-369-1559
Practice Address - Fax:617-369-1566
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator