Provider Demographics
NPI:1598302358
Name:WRIGHT, MICHELLIE ANN (MA)
Entity Type:Individual
Prefix:
First Name:MICHELLIE
Middle Name:ANN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 EL RANCHO DR APT 56A
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3521
Mailing Address - Country:US
Mailing Address - Phone:775-507-1648
Mailing Address - Fax:
Practice Address - Street 1:1260 EL RANCHO DR APT 56A
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3521
Practice Address - Country:US
Practice Address - Phone:775-507-1648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-28
Last Update Date:2019-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst