Provider Demographics
NPI:1356804751
Name:WRIGHT, KELSEY NORAH
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:NORAH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-5675
Mailing Address - Country:US
Mailing Address - Phone:404-271-6843
Mailing Address - Fax:
Practice Address - Street 1:3118 WAKEFIELD ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-5675
Practice Address - Country:US
Practice Address - Phone:404-271-6843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician