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NPI Code Detail

MEDICARE: JUDITH C WHEELER LMLP

MEDICARE: JUDITH C WHEELER LMLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist0575KS

General Provider Information

NPI Number : 1396837514
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH C WHEELER LMLP
Provider Business Mailing Address
First Line : 911 E CENTENNIAL DR
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-6601
Country : US
Telephone Number : 620-235-5130
Fax Number :
Provider Business Practice Location Address
First Line : 810 CEDAR ST
Second Line :
City : GIRARD
State : KS
Zip : 66743-2056
Country : US
Telephone Number : 620-724-8806
Fax Number : 620-724-6170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 07/08/2007

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Directions to “ JUDITH C WHEELER LMLP” Practice Location

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