Individual
TYISHA BRONTA WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 IRWIN ST, PHILLIPSBURG, NJ 08865-2439
(186) 268-4253
Mailing address
207 IRWIN ST, PHILLIPSBURG, NJ 08865-2439
(186) 268-4253
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
37AC00540300
NJ
101YP2500X
Professional Counselor
Primary
37PC00937300
NJ
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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