Provider Demographics
NPI:1629792932
Name:WRIGHT, DWAYNE COWLES (MS, MED, PHD)
Entity Type:Individual
Prefix:DR
First Name:DWAYNE
Middle Name:COWLES
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS, MED, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3874 APPALOOSA TRL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7206
Mailing Address - Country:US
Mailing Address - Phone:216-262-2474
Mailing Address - Fax:
Practice Address - Street 1:4210 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-0401
Practice Address - Country:US
Practice Address - Phone:706-364-6576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor