Provider Demographics
NPI:1487396560
Name:WRIGHT, VINCINCIA LANELL
Entity type:Individual
Prefix:
First Name:VINCINCIA
Middle Name:LANELL
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 1:6021 FAIRMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4040
Mailing Address - Country:US
Mailing Address - Phone:281-769-2238
Mailing Address - Fax:281-769-2164
Practice Address - Street 1:6021 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4040
Practice Address - Country:US
Practice Address - Phone:281-769-2238
Practice Address - Fax:281-769-2164
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional