Provider Demographics
NPI:1063213783
Name:WRIGHT, BILLIE BREANA
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:BREANA
Last Name:WRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 SHALLOWFORD RD APT 2
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-5407
Mailing Address - Country:US
Mailing Address - Phone:404-840-8112
Mailing Address - Fax:
Practice Address - Street 1:6220 SHALLOWFORD RD APT 2
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-5407
Practice Address - Country:US
Practice Address - Phone:404-840-8112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician