Provider Demographics
NPI:1699442442
Name:WRIGHT, ADAIAH L
Entity type:Individual
Prefix:
First Name:ADAIAH
Middle Name:L
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 1:1317 VIENNA RD SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-5640
Mailing Address - Country:US
Mailing Address - Phone:330-880-6414
Mailing Address - Fax:
Practice Address - Street 1:524 W PARK AVE STE 1
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-2587
Practice Address - Country:US
Practice Address - Phone:330-753-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health