Provider Demographics
NPI:1942800990
Name:WRIGHT, TARA ELECTAALLEEN
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:ELECTAALLEEN
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 1:1899 GERMAN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PATRIOT
Mailing Address - State:OH
Mailing Address - Zip Code:45658-9148
Mailing Address - Country:US
Mailing Address - Phone:740-339-3854
Mailing Address - Fax:
Practice Address - Street 1:1086 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1396
Practice Address - Country:US
Practice Address - Phone:740-446-9129
Practice Address - Fax:740-446-9021
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator