Provider Demographics
NPI:1760434096
Name:WRIGHT, DEBORAH MARIE (PH D)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:MARIE
Other - Last Name:ROTHWEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:MU ASSESSMENT AND CONSULTATION CLINIC
Mailing Address - Street 2:205 LEWIS HALL
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65211-0001
Mailing Address - Country:US
Mailing Address - Phone:573-882-5092
Mailing Address - Fax:573-884-3399
Practice Address - Street 1:MU ASSESSMENT AND CONSULTATION CLINIC
Practice Address - Street 2:205 LEWIS HALL
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65211
Practice Address - Country:US
Practice Address - Phone:573-884-0377
Practice Address - Fax:573-884-3399
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY01743103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10856751OtherCAQH PROVIDER #
MO70637Medicare ID - Type Unspecified