Provider Demographics
NPI:1962502641
Name:WRIGHT, MERILYN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MERILYN
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5926 W 3400 S
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84339-9801
Mailing Address - Country:US
Mailing Address - Phone:435-752-9767
Mailing Address - Fax:
Practice Address - Street 1:550 N MAIN ST STE 222
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-3957
Practice Address - Country:US
Practice Address - Phone:435-512-8830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4797974-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT205030541OtherTAX IDENTIFICATION NUMBER