Provider Demographics
NPI:1871279133
Name:WRIGHT, JUSTINE (AUD)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 SPINNAKER BAY DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80528-7533
Mailing Address - Country:US
Mailing Address - Phone:970-528-5060
Mailing Address - Fax:
Practice Address - Street 1:8201 SPINNAKER BAY DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80528-7533
Practice Address - Country:US
Practice Address - Phone:970-528-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001215231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist