Provider Demographics
NPI:1255409397
Name:WRIGHT, NANCY J (MA, CCC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:J
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 ADAMS TRL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-4321
Mailing Address - Country:US
Mailing Address - Phone:405-341-5651
Mailing Address - Fax:
Practice Address - Street 1:2812 ADAMS TRL
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-4321
Practice Address - Country:US
Practice Address - Phone:405-341-5651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK352235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist