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General NPI Number Information
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NPI Number | 1811496276
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Entity Type | Individual
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Provider Name | MICHELLE WHEATON LSW
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Gender | Female
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1300 E PAINT ST
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-1676
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Country | US
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Telephone | 740-335-6935
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6179 4449 ST RT 159
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-6179
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Country | US
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Telephone | 740-775-1260
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S1701833
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License Number State | OH
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