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General NPI Number Information
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NPI Number | 1174741607
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Entity Type | Organization
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Legal Business Name | MISTI JONES WHEELER MS INC.
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Dates
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Enumeration Date | 04/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 805 JOHNSTOWN RD
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City | BECKLEY
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State | WV
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Zip | 25801-4935
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Country | US
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Telephone | 304-929-3945
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Fax | 304-929-3945
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Provider Business Mailing Address
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Address Line | 214 WOODLAWN AVE
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City | BECKLEY
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State | WV
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Zip | 25801-5407
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Country | US
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Telephone | 304-575-6718
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Fax | 304-929-3945
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Authorized Official
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Title or Position | OWNER
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Name | MISTI DAWN JONES- WHEELER
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Credential | M.S.
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Telephone | 304-929-3945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 828
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License Number State | WV
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