Basic Information
Provider Information
NPI: 1003152679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: WHITNEY
MiddleName: ANNE
NamePrefix: MS.
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3185 N BARNSBURY TER
Address2:  
City: FAYETTEVILLE
State: AR
PostalCode: 727036579
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3185 N BARNSBURY TER
Address2:  
City: FAYETTEVILLE
State: AR
PostalCode: 727036579
CountryCode: US
TelephoneNumber: 4792251863
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/29/2012
LastUpdateDate: 12/29/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOTR2383ARY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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