Provider Demographics
NPI:1598110173
Name:WRIGHT, TAMMY
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
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 1:3041 54TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:KS
Mailing Address - Zip Code:66512
Mailing Address - Country:US
Mailing Address - Phone:785-581-8080
Mailing Address - Fax:
Practice Address - Street 1:104 N 7 HWY
Practice Address - Street 2:STE K
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2749
Practice Address - Country:US
Practice Address - Phone:816-220-2239
Practice Address - Fax:816-220-2239
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014029707237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist