Provider Demographics
NPI:1811991730
Name:WRIGHT, MARY BETH (MS, F-AAA)
Entity type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MS, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PARK AVE W
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3702
Mailing Address - Country:US
Mailing Address - Phone:419-524-6882
Mailing Address - Fax:419-522-7822
Practice Address - Street 1:650 PARK AVE W
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3702
Practice Address - Country:US
Practice Address - Phone:419-524-6882
Practice Address - Fax:419-522-7822
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-0606231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WR4012831Medicare ID - Type Unspecified
OHP00898Medicare UPIN