Individual
KELLI GENTRY WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-23-3419
OR
1041C0700X
Clinical Social Worker
Primary
L6031
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014274
—
OR
01
—
4490398
DRIVERS LICENSE
OR
05
—
500699801
—
OR
Enumeration date
04/29/2009
Last updated
08/30/2024
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