Provider Demographics
NPI:1881473551
Name:WRIGHT, CASEY MICHAEL (SLPA)
Entity type:Individual
Prefix:MR
First Name:CASEY
Middle Name:MICHAEL
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E TUDOR RD STE 9
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1036
Mailing Address - Country:US
Mailing Address - Phone:907-332-0065
Mailing Address - Fax:
Practice Address - Street 1:1515 E TUDOR RD STE 9
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1036
Practice Address - Country:US
Practice Address - Phone:907-332-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1359822355S0801X
AK171M00000X
ME1359822355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant