| Doctor Name: | MS. SUSAN WRIGHT |
| NPI Number: | 1053415604 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCS2139 |
| License Number: | 2139 |
| Business Practice Address: | 311 Prince Royal Dr Creative Life Change Institute Corte Madera, CA - 94925 |
| Business Phone Number: | 4159272748 |
| Business Fax Number: | 4159277948 |
| Mailing Address: | 311 Prince Royal Dr, Creative Life Change Institute CORTE MADERA |
| State: | CA |
| Postal Code: | 94925 |
| Phone Number: | 4159272748 |
| Fax Number: | 4159277948 |
| NPI Enumeration Date: | 09/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |