Provider Demographics
NPI:1598088676
Name:WRIGHT, R. MICKEY (PHD)
Entity Type:Individual
Prefix:
First Name:R.
Middle Name:MICKEY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 SO. JAMAICA CT.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AURORA, COLORADO 80014
Mailing Address - State:UNITED STATES OF AMERICA
Mailing Address - Zip Code:80014
Mailing Address - Country:UM
Mailing Address - Phone:303-726-9373
Mailing Address - Fax:303-925-1093
Practice Address - Street 1:3090 S JAMAICA CT
Practice Address - Street 2:SUITE 200
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2658
Practice Address - Country:US
Practice Address - Phone:303-726-9373
Practice Address - Fax:303-925-1093
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO074106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist