Provider Demographics
NPI:1710662853
Name:WHEELER PEDIATRIC SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:WHEELER PEDIATRIC SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:765-914-5381
Mailing Address - Street 1:117 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-9114
Mailing Address - Country:US
Mailing Address - Phone:567-206-0938
Mailing Address - Fax:567-429-0592
Practice Address - Street 1:117 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-9114
Practice Address - Country:US
Practice Address - Phone:567-206-0938
Practice Address - Fax:567-429-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty