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General NPI Number Information
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NPI Number | 1760807150
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Entity Type | Organization
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Legal Business Name | ALLISON WHEELER
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Dates
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Enumeration Date | 02/22/2014
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Last Update Date | 02/22/2014
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Provider Practice Location Address
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Address Line | 11166 HURON ST #26B
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City | NORTHGLENN
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State | CO
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Zip | 80234-3339
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Country | US
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Telephone | 720-432-2102
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Fax |
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Provider Business Mailing Address
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Address Line | 11166 HURON ST #26B
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City | NORTHGLENN
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State | CO
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Zip | 80234-3339
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Country | US
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Telephone | 720-432-2102
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ALLISON WHEELER
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Credential | MS
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Telephone | 720-432-2102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NLC13080
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License Number State | CO
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