Doctor Name: | CLINT A. WHEELER |
NPI Number: | 1023367562 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | |
Business Practice Address: | 815 W 5th North St Morristown, TN - 378143810 |
Business Phone Number: | 4235865032 |
Business Fax Number: | 4235818473 |
Mailing Address: | 6350 W Andrew Johnson Hwy, Department 100 TALBOTT |
State: | TN |
Postal Code: | 378778605 |
Phone Number: | 8003553565 |
Fax Number: | 4237142355 |
NPI Enumeration Date: | 08/30/2012 |
NPI Last Update Date: | 07/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |