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General NPI Number Information
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NPI Number | 1619402971
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Entity Type | Individual
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Provider Name | CHRISTINA WHEELER M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 117 WISTERIA DR
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City | FREMONT
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State | OH
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Zip | 43420-9114
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Country | US
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Telephone | 567-206-0938
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Fax | 567-429-0592
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Provider Business Mailing Address
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Address Line | 117 WISTERIA DR
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City | FREMONT
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State | OH
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Zip | 43420-9114
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Country | US
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Telephone | 567-206-0938
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Fax | 419-429-0592
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.10302
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License Number State | OH
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