Provider Demographics
NPI:1740647601
Name:WRIGHT, PERRY REBEKAH (MT-BC, LPMT)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:REBEKAH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MT-BC, LPMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 CARUSO CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6608
Mailing Address - Country:US
Mailing Address - Phone:229-347-2767
Mailing Address - Fax:
Practice Address - Street 1:4280 HICKORY FLAT HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-6633
Practice Address - Country:US
Practice Address - Phone:770-345-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-24
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMUT000138225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist