Provider Demographics
NPI:1760807150
Name:ALLISON WHEELER
Entity Type:Organization
Organization Name:ALLISON WHEELER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:720-432-2102
Mailing Address - Street 1:11166 HURON ST
Mailing Address - Street 2:#26B
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3339
Mailing Address - Country:US
Mailing Address - Phone:720-432-2102
Mailing Address - Fax:
Practice Address - Street 1:11166 HURON ST
Practice Address - Street 2:#26B
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-3339
Practice Address - Country:US
Practice Address - Phone:720-432-2102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-22
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC13080251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health