Provider Demographics
NPI:1497952956
Name:WRIGHT, MARIANNA BROGAN (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNA
Middle Name:BROGAN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 PRINCE AVE
Mailing Address - Street 2:ARMC REEHAB DEPT.
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2797
Mailing Address - Country:US
Mailing Address - Phone:706-475-3511
Mailing Address - Fax:706-475-6771
Practice Address - Street 1:1199 PRINCE AVE
Practice Address - Street 2:ARMC REHAB DEPT.
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2797
Practice Address - Country:US
Practice Address - Phone:706-475-3511
Practice Address - Fax:706-475-6771
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1611235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist