Provider Demographics
NPI:1750623088
Name:WRIGHT, KIVETTE
Entity type:Individual
Prefix:
First Name:KIVETTE
Middle Name:
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 1:4565 MARSHALL RUN CIR APT 304
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5878
Mailing Address - Country:US
Mailing Address - Phone:804-551-8207
Mailing Address - Fax:
Practice Address - Street 1:4565 MARSHALL RUN CIR APT 304
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5878
Practice Address - Country:US
Practice Address - Phone:804-551-8207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health