Provider Demographics
NPI:1609663103
Name:WRIGHT, DESTINY NICOLE (CHW)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:NICOLE
Last Name:WRIGHT
Suffix:
Gender:
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26226 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1418
Mailing Address - Country:US
Mailing Address - Phone:248-241-2620
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD STE 104
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1137
Practice Address - Country:US
Practice Address - Phone:248-241-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker