Provider Demographics
NPI:1811339070
Name:WRIGHT-AGARD, EUGENIA ANN (LMHC INTERN)
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:ANN
Last Name:WRIGHT-AGARD
Suffix:
Gender:F
Credentials:LMHC INTERN
Other - Prefix:
Other - First Name:EUGENIA
Other - Middle Name:ANN
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC INTERN
Mailing Address - Street 1:16 N CLYDE AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5420
Mailing Address - Country:US
Mailing Address - Phone:407-791-1900
Mailing Address - Fax:866-816-8621
Practice Address - Street 1:16 N CLYDE AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5420
Practice Address - Country:US
Practice Address - Phone:407-791-1900
Practice Address - Fax:866-816-8621
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 10545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health