Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2670 | CO |
N | 103TC0700X | Clinical Psychologist | 2670 | CO |
N | 102L00000X | Psychologist | 2670 | CO |
N | 103T00000X | Psychologist | 2670 | CO |
N | 102L00000X | Psychologist | 5331 | MD |
N | 103T00000X | Psychologist | 5331 | MD |
N | 103TF0200X | Forensic Psychologist | 2670 | CO |
Y | 103TH0004X | Health Psychologist | 5531 | MD |
N | 103TH0100X | Health Service | 2670 | CO |
N | 103TR0400X | Rehabilitation Psychologist | 2670 | CO |
NPI | 1295770758 |
---|---|
Provider Name | Dr. Jennifer Bugg Wright |
First Address | Boyds, MD 20841-6017 |
Second Address | Gaithersburg, MD 20878-1676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 12/07/2017 |