Provider Demographics
NPI:1891126074
Name:WRIGHT, KATHI LOUISE (MS SLP-CCC/L)
Entity Type:Individual
Prefix:
First Name:KATHI
Middle Name:LOUISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MS SLP-CCC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 W 1ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT ANTHONY
Mailing Address - State:ID
Mailing Address - Zip Code:83445-1201
Mailing Address - Country:US
Mailing Address - Phone:208-624-7542
Mailing Address - Fax:208-624-3385
Practice Address - Street 1:168 S 1ST ST
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:ID
Practice Address - Zip Code:83420-5738
Practice Address - Country:US
Practice Address - Phone:208-652-7601
Practice Address - Fax:208-652-7602
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-2359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist