Provider Demographics
NPI:1972112951
Name:WRIGHT, CORI L (MA, L-SLP, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CORI
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA, L-SLP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-1130
Mailing Address - Country:US
Mailing Address - Phone:225-936-1881
Mailing Address - Fax:225-664-5660
Practice Address - Street 1:1090 ROBBIE ST
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2500
Practice Address - Country:US
Practice Address - Phone:225-664-4223
Practice Address - Fax:225-664-5660
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
LA6491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1972112951Medicaid