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General NPI Number Information
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NPI Number | 1972151546
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Entity Type | Individual
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Provider Name | AMANDA NICOLE WHEELER PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 1303 10TH ST E UNIT C
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City | PALMETTO
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State | FL
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Zip | 34221-4100
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Country | US
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Telephone | 941-479-7866
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 67TH CT E
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City | BRADENTON
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State | FL
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Zip | 34203-9738
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Country | US
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Telephone | 317-468-3773
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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