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General NPI Number Information
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NPI Number | 1467166553
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Entity Type | Individual
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Provider Name | AYANA WHEELER
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Gender | Female
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 8415 EXPLORER DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1033
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Country | US
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Telephone | 719-332-4689
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Fax |
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Provider Business Mailing Address
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Address Line | 5240 PEACEFUL PL
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-3301
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Country | US
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Telephone | 859-490-5364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0008349
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License Number State | CO
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