Provider Demographics
NPI:1528540275
Name:WRIGHT, ELIZABETH ASHLEY
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ASHLEY
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 1:1602 GOVERNORS DR APT 2521
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-9440
Mailing Address - Country:US
Mailing Address - Phone:850-418-4998
Mailing Address - Fax:
Practice Address - Street 1:7450 LEANDRAS LN
Practice Address - Street 2:
Practice Address - City:WALNUT HILL
Practice Address - State:FL
Practice Address - Zip Code:32568-2038
Practice Address - Country:US
Practice Address - Phone:850-418-4998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW117551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical