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General NPI Number Information
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NPI Number | 1922724210
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Entity Type | Individual
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Provider Name | LEMUAL J. WHEATLEY III
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Gender | Male
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 4324 W HARVARD AVE
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City | FRESNO
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State | CA
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Zip | 93722-5183
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Country | US
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Telephone | 559-681-1470
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Fax |
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Provider Business Mailing Address
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Address Line | 2587 S ARGYLE AVE
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City | FRESNO
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State | CA
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Zip | 93727-8827
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Country | US
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Telephone | 559-273-6142
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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