Basic Information
Provider Information
NPI: 1871248518
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: RHONDA
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5750A SOUTHLAND DR
Address2:  
City: MOBILE
State: AL
PostalCode: 366933316
CountryCode: US
TelephoneNumber: 2514502211
FaxNumber: 2516627297
Practice Location
Address1: 13833 TAPIA AVE
Address2:  
City: BAYOU LA BATRE
State: AL
PostalCode: 365092515
CountryCode: US
TelephoneNumber: 2518248312
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/21/2022
LastUpdateDate: 02/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X4555ALY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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