Most Relevant Information
Provider Data
| NPI Number: | 1003527615 |
| Provider Name: | TIMOTHY ROBERT WRIGHT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/06/2022 |
| Last Updated: | 12/06/2022 |
Provider Practice Location
108 W MARKET ST
BLOOMINGTON
IL
617013918
Practice Location Phone/Fax
| Phone: | 3098275351 |
| Fax: |
Provider Mailing Location
108 W MARKET ST
BLOOMINGTON
IL
617013918
Provider Mailing Phone/Fax
| Phone: | 3098275351 |
| Fax: |