Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003353749 |
---|---|
Provider Name | Heckeisha Wright |
First Address | Pembroke Pines, FL 33025-4549 |
Second Address | Pembroke Pines, FL 33025-4549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2017 |
Last Update Date | 19/01/2017 |