Provider Demographics
NPI:1043340086
Name:WHEELER, TRACEY LAUREN (BACHELOR OF ART)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:LAUREN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:BACHELOR OF ART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CHAPMAN BLVD
Mailing Address - Street 2:C-11
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-1669
Mailing Address - Country:US
Mailing Address - Phone:732-674-3340
Mailing Address - Fax:
Practice Address - Street 1:128 CREST HAVEN RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1651
Practice Address - Country:US
Practice Address - Phone:609-465-4100
Practice Address - Fax:609-465-2588
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor