Provider Demographics
NPI:1518612126
Name:WRIGHT, CORISSA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CORISSA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CORI
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC
Mailing Address - Street 1:9229 E 37TH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2025
Mailing Address - Country:US
Mailing Address - Phone:316-655-3403
Mailing Address - Fax:316-267-8191
Practice Address - Street 1:9229 E 37TH ST N STE 201
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2025
Practice Address - Country:US
Practice Address - Phone:316-655-3403
Practice Address - Fax:316-267-8191
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist