Provider Demographics
NPI:1699110056
Name:WRIGHT, GREGORY S (PC-CR)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:S
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PC-CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 SAWMILL TRL NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4929
Mailing Address - Country:US
Mailing Address - Phone:330-417-8168
Mailing Address - Fax:
Practice Address - Street 1:754 SAWMILL TRL NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-4929
Practice Address - Country:US
Practice Address - Phone:330-417-8168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 1100375101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor