Doctor Name: | ANGELA ROCHELLE WHEELER |
NPI Number: | 1881025591 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC006372 |
Business Practice Address: | 61 Corsair Cir Port Wentworth, GA - 314078529 |
Business Phone Number: | 9126559846 |
Business Fax Number: | |
Mailing Address: | 61 Corsair Cir, PORT WENTWORTH |
State: | GA |
Postal Code: | 314078529 |
Phone Number: | 9126559846 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2013 |
NPI Last Update Date: | 12/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LPC006372 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |