Provider Demographics
NPI:1629360334
Name:WRIGHT, EMILY JO
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:JO
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 1:8727 W BRYN MAWR AVE
Mailing Address - Street 2:#403
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3740
Mailing Address - Country:US
Mailing Address - Phone:309-242-2295
Mailing Address - Fax:
Practice Address - Street 1:8727 W BRYN MAWR AVE
Practice Address - Street 2:#403
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3740
Practice Address - Country:US
Practice Address - Phone:309-242-2295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst