Provider Demographics
NPI:1154462976
Name:WHEELER, AMBER DAWN (BS)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DAWN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 HAYFIELD SQ
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-1464
Mailing Address - Country:US
Mailing Address - Phone:931-723-3693
Mailing Address - Fax:
Practice Address - Street 1:1420 NEAL ST STE 202
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4332
Practice Address - Country:US
Practice Address - Phone:931-525-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health