Provider Demographics
NPI:1831944032
Name:WRIGHT, CHASTITY
Entity type:Individual
Prefix:
First Name:CHASTITY
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 1:8201 PEACHTREE LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4254
Mailing Address - Country:US
Mailing Address - Phone:470-893-7105
Mailing Address - Fax:
Practice Address - Street 1:8201 PEACHTREE LANDING CIR
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-4254
Practice Address - Country:US
Practice Address - Phone:470-893-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician