Provider Demographics
NPI:1447875901
Name:WRIGHT, QIANA LATRICE
Entity type:Individual
Prefix:
First Name:QIANA
Middle Name:LATRICE
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 1:10806 MARATHON DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4743
Mailing Address - Country:US
Mailing Address - Phone:202-744-4807
Mailing Address - Fax:
Practice Address - Street 1:8181 PROFESSIONAL PL
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2226
Practice Address - Country:US
Practice Address - Phone:240-813-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health