Provider Demographics
NPI:1821369299
Name:WRIGHT, EDDIE STRAW JR (SOCIAL WORKER)
Entity Type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:STRAW
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 EDWINSTOWE AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1162
Mailing Address - Country:US
Mailing Address - Phone:910-286-0125
Mailing Address - Fax:
Practice Address - Street 1:401 EDWINSTOWE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1162
Practice Address - Country:US
Practice Address - Phone:910-286-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0075931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical