Provider Demographics
NPI:1740375294
Name:WRIGHT, ANGELA F (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:F
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47330-1228
Mailing Address - Country:US
Mailing Address - Phone:765-855-4237
Mailing Address - Fax:765-855-4238
Practice Address - Street 1:201 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IN
Practice Address - Zip Code:47330-1228
Practice Address - Country:US
Practice Address - Phone:765-855-4237
Practice Address - Fax:765-855-4238
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043440B103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical