Provider Demographics
NPI:1043704695
Name:WRIGHT, CORTNEE (MA)
Entity type:Individual
Prefix:MRS
First Name:CORTNEE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:CORTNEE
Other - Middle Name:ANN
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7911 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2601
Mailing Address - Country:US
Mailing Address - Phone:210-930-3669
Mailing Address - Fax:
Practice Address - Street 1:7911 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2601
Practice Address - Country:US
Practice Address - Phone:210-930-3669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional