Provider Demographics
NPI:1508197922
Name:WRIGHT, BRIAN L (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 GREGORY PL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-5040
Mailing Address - Country:US
Mailing Address - Phone:561-346-6447
Mailing Address - Fax:
Practice Address - Street 1:235 GREGORY PL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-5040
Practice Address - Country:US
Practice Address - Phone:561-346-6447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist