Provider Demographics
NPI:1992347215
Name:WRIGHT, KATHERINE M
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
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 1:161 JD TOWLES DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-8654
Mailing Address - Country:US
Mailing Address - Phone:682-900-1444
Mailing Address - Fax:682-900-1444
Practice Address - Street 1:12333 BEAR PLZ STE 200
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0215
Practice Address - Country:US
Practice Address - Phone:682-900-1444
Practice Address - Fax:682-900-1444
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-18-72810106S00000X
TX5064103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician