Provider Demographics
NPI:1245462373
Name:WRIGHT, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S W S YOUNG DR STE 104C
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-3312
Mailing Address - Country:US
Mailing Address - Phone:512-293-7258
Mailing Address - Fax:
Practice Address - Street 1:3800 S W S YOUNG DR STE 104C
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3312
Practice Address - Country:US
Practice Address - Phone:512-293-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist