| Doctor Name: | MS. MARIJANE WHEELER |
| NPI Number: | 1174848824 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LISAC |
| License Number: | 11385 |
| Business Practice Address: | Route 7 Box 777 Chinle, AZ - 865030777 |
| Business Phone Number: | 9286742190 |
| Business Fax Number: | 9286742198 |
| Mailing Address: | Box 777 Route 7, CHINLE |
| State: | AZ |
| Postal Code: | 865030777 |
| Phone Number: | 9286742190 |
| Fax Number: | 9286742198 |
| NPI Enumeration Date: | 04/06/2010 |
| NPI Last Update Date: | 04/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 11385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |