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Provider Information for 1477333102


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SHANYAH WRIGHT LMFT


Sex: Female

NPI: 1477333102
Last Updated: 2023-10-02
Certification Date: 2023-09-30

Details

NameValue
NPI1477333102
Enumeration Date2023-10-02
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 139 DOVE LN UNIT D
MIDDLETOWN, CT 06457-6223
United States

Phone: 215-827-7467 | Fax:
 
Primary Practice Address 139 DOVE LN UNIT D
MIDDLETOWN, CT 06457-6223
United States

Phone: 215-827-7467 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist CT003175