Basic Information
| Provider Information | |||||||||
| NPI: | 1407214786 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 342 HIGHWAY 421 N | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 400068696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025482573 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7509 CHARLESTOWN PIKE | ||||||||
| Address2: | |||||||||
| City: | CHARLESTOWN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471119623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122564686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2016 | ||||||||
| LastUpdateDate: | 02/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.