Provider Demographics
NPI:1740058619
Name:TAMARA MARIE WRIGHT MS CMHC LMHC PLLC
Entity type:Organization
Organization Name:TAMARA MARIE WRIGHT MS CMHC LMHC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/TELEHEALTH PRIVATE PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC, LMHC
Authorized Official - Phone:801-815-1706
Mailing Address - Street 1:PO BOX 521718
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84152-1718
Mailing Address - Country:US
Mailing Address - Phone:801-463-2524
Mailing Address - Fax:
Practice Address - Street 1:1996 S LAKE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3135
Practice Address - Country:US
Practice Address - Phone:801-815-1706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health