Provider Demographics
NPI:1770391328
Name:WRIGHT, CALYN R (CDCA190197)
Entity type:Individual
Prefix:
First Name:CALYN
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CDCA190197
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5471 SCIOTO DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1310
Mailing Address - Country:US
Mailing Address - Phone:614-470-4248
Mailing Address - Fax:
Practice Address - Street 1:5471 SCIOTO DARBY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1310
Practice Address - Country:US
Practice Address - Phone:614-470-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA190197101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty