Provider Demographics
NPI:1720310303
Name:WRIGHT, DENISE V (BCBA, LBA, PHD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:V
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:BCBA, LBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 EASTLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-1836
Mailing Address - Country:US
Mailing Address - Phone:516-640-0798
Mailing Address - Fax:
Practice Address - Street 1:4250 SUNRISE HWY STE 206
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5344
Practice Address - Country:US
Practice Address - Phone:516-640-0798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1095079103K00000X
NY026509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst