Provider Demographics
NPI:1700193976
Name:GILMORE-WHEELER, YVETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:
Last Name:GILMORE-WHEELER
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 1:730 W CHEYENNE AVE STE 40
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7849
Mailing Address - Country:US
Mailing Address - Phone:702-862-6997
Mailing Address - Fax:
Practice Address - Street 1:730 W CHEYENNE AVE STE 40
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7849
Practice Address - Country:US
Practice Address - Phone:702-862-6997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13441101Y00000X, 101YP1600X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral