Healthcare Provider Details

I. General information

NPI: 1245942028
Provider Name (Legal Business Name): A. RENEE WHEELER PSY.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2022
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 MILLINGTON SQ
BEL AIR MD
21015-8309
US

IV. Provider business mailing address

1976 MILLINGTON SQ
BEL AIR MD
21015-8309
US

V. Phone/Fax

Practice location:
  • Phone: 443-619-0653
  • Fax:
Mailing address:
  • Phone: 443-619-0653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA RENEE WHEELER
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 443-619-0653