Provider Demographics
NPI:1336739556
Name:WRIGHT, ANNA GOODBREAD (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:GOODBREAD
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 1:719 RAVENEL RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1835
Mailing Address - Country:US
Mailing Address - Phone:706-373-7993
Mailing Address - Fax:
Practice Address - Street 1:2945 WALTON WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-3827
Practice Address - Country:US
Practice Address - Phone:706-842-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist