Provider Demographics
NPI:1124443742
Name:WRIGHT, CHANTE' LASHALLE
Entity type:Individual
Prefix:
First Name:CHANTE'
Middle Name:LASHALLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 DAISY LEE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-6544
Mailing Address - Country:US
Mailing Address - Phone:702-321-3144
Mailing Address - Fax:
Practice Address - Street 1:6116 DAISY LEE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-6544
Practice Address - Country:US
Practice Address - Phone:702-321-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner