Provider Demographics
NPI:1235280702
Name:WHEELER, ANDREA BRITT (OT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:BRITT
Last Name:WHEELER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2829
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-2829
Mailing Address - Country:US
Mailing Address - Phone:912-756-5699
Mailing Address - Fax:
Practice Address - Street 1:2333 N BRENTWOOD CIR
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9323
Practice Address - Country:US
Practice Address - Phone:352-746-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002489225X00000X
FLOT18859225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000844973BMedicaid