Provider Demographics
NPI:1245396308
Name:WHEATON, JANILEE BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANILEE
Middle Name:BETH
Last Name:WHEATON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 PEARL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2112
Mailing Address - Country:US
Mailing Address - Phone:440-845-9011
Mailing Address - Fax:440-845-9013
Practice Address - Street 1:5851 PEARL RD STE 305
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-2112
Practice Address - Country:US
Practice Address - Phone:440-845-9011
Practice Address - Fax:440-845-9013
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4059103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHWHCP11472Medicare ID - Type Unspecified