Provider Demographics
NPI:1437586823
Name:WHEELER, LYNDSAY M (MED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LYNDSAY
Middle Name:M
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:MS
Other - First Name:LYNDSAY
Other - Middle Name:M
Other - Last Name:PENNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:2020 E HEBRON PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1618
Mailing Address - Country:US
Mailing Address - Phone:469-892-7500
Mailing Address - Fax:469-575-3002
Practice Address - Street 1:2020 E HEBRON PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1618
Practice Address - Country:US
Practice Address - Phone:469-892-7500
Practice Address - Fax:469-575-3002
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0-11-4128103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst