Provider Demographics
NPI:1508287681
Name:WRIGHT, CARRIE (SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3026 HIDDEN LAKE PT
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4455
Mailing Address - Country:US
Mailing Address - Phone:270-685-9499
Mailing Address - Fax:270-685-9443
Practice Address - Street 1:1605 SCHERM RD
Practice Address - Street 2:STE 3
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-5300
Practice Address - Country:US
Practice Address - Phone:270-685-9499
Practice Address - Fax:270-685-9443
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist