Provider Demographics
NPI:1710247432
Name:WRIGHT, TAMI ANN (PHD, LPC, SCL)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:ANN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHD, LPC, SCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 W LONG LAKE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-2769
Mailing Address - Country:US
Mailing Address - Phone:248-642-6066
Mailing Address - Fax:248-642-5739
Practice Address - Street 1:74 W LONG LAKE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-2769
Practice Address - Country:US
Practice Address - Phone:248-642-6066
Practice Address - Fax:248-642-5739
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007198101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor