Provider Demographics
NPI:1154648038
Name:WHEELER, SARA (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 WILDWOOD CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1143
Mailing Address - Country:US
Mailing Address - Phone:314-871-2437
Mailing Address - Fax:314-821-2423
Practice Address - Street 1:815 WILDWOOD CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1143
Practice Address - Country:US
Practice Address - Phone:314-871-2437
Practice Address - Fax:314-821-2423
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist