Provider Demographics
NPI:1750754578
Name:PATRICIA M WRIGHT PHD &ASSOCIATES, LLC
Entity type:Organization
Organization Name:PATRICIA M WRIGHT PHD &ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST
Authorized Official - Phone:662-892-2885
Mailing Address - Street 1:6928 COBBLESTONE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-8300
Mailing Address - Country:US
Mailing Address - Phone:662-892-2885
Mailing Address - Fax:662-892-2889
Practice Address - Street 1:6928 COBBLESTONE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-8300
Practice Address - Country:US
Practice Address - Phone:662-892-2885
Practice Address - Fax:662-892-2889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS33519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty