Provider Demographics
NPI:1437020344
Name:WRIGHT, MARY SALINA
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:SALINA
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 1:124 E MAIN ST STE B4
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-5623
Mailing Address - Country:US
Mailing Address - Phone:580-436-7206
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:2510 CHICKASAW BLVD
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1341
Practice Address - Country:US
Practice Address - Phone:580-222-2884
Practice Address - Fax:580-272-5757
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health