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General NPI Number Information
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NPI Number | 1073693990
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Entity Type | Organization
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Legal Business Name | GEORGE LARRY WHEELER SR
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 3000 CONNECTICUT AVE NW SUITE 321
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City | WASHINGTON
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State | DC
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Zip | 20008-2509
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Country | US
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Telephone | 202-265-2343
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Fax | 202-248-9076
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Provider Business Mailing Address
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Address Line | 3000 CONNECTICUT AVE NW SUITE 321
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City | WASHINGTON
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State | DC
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Zip | 20008-2509
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Country | US
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Telephone | 202-265-2343
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Fax | 202-248-9076
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | DR. GEORGE LARRY WHEELER SR.
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Credential | PSYD,MBA,CEAP,SAP,L,
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Telephone | 202-265-2343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701003368
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License Number State | VA
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