Provider Demographics
NPI:1992071997
Name:WRIGHT, ANDREW ANTONIO (OT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ANTONIO
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 SUMMER PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3421
Mailing Address - Country:US
Mailing Address - Phone:410-665-5701
Mailing Address - Fax:
Practice Address - Street 1:1200 STEUART ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5317
Practice Address - Country:US
Practice Address - Phone:833-769-3779
Practice Address - Fax:410-994-2705
Is Sole Proprietor?:No
Enumeration Date:2012-03-24
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05032225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist