Provider Demographics
NPI:1023087350
Name:WRIGHT, PATRICIA MICHELE (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MICHELE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 GETWELL RD
Mailing Address - Street 2:BLDG B, STE 4
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-7328
Mailing Address - Country:US
Mailing Address - Phone:662-349-2979
Mailing Address - Fax:662-349-2978
Practice Address - Street 1:5627 GETWELL RD
Practice Address - Street 2:BLDG B, STE 4
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-7328
Practice Address - Country:US
Practice Address - Phone:662-349-2979
Practice Address - Fax:662-349-2978
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1847103T00000X
MS33519103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist